Preferences of Pregnant Women and Healthcare Professionals on First-Trimester Ultrasound Screening for Fetal Anomalies: A Discrete Choice Experiment

Objective: The first-trimester anomaly scan (FTAS) allows early detection of fetal structural anomalies. Decisions on timing and scan protocol influence its performance. Understanding how pregnant women and healthcare professionals value these aspects is essential for shaping screening programs. This study aims to identify which aspects of first-trimester ultrasound screening are considered most important. Method: A discrete choice experiment was conducted between July and August 2025. It included five attributes: sensitivity (30%, 50%, 90%), gestational age at diagnosis (12, 16, 22 weeks), false positive rate (20%, 40%, 60%), false negative rate (0.1%, 1%, 5%) and types of anomalies detected (most severe only vs. most severe and other). Additionally, general attitudes toward the FTAS were assessed. Results: Questionnaires were completed by 1963 pregnant women who opted for FTAS and 1068 healthcare professionals (203 medical doctors, 865 primary care professionals). Most important attributes for pregnant women and healthcare professionals were sensitivity and false positive rate. 85.1% of pregnant women and 58.1% of healthcare professionals (strongly) agreed that the FTAS should be available to pregnant women. Conclusion: Pregnant women and healthcare professionals support FTAS availability. Optimization should focus on maximizing sensitivity and minimizing false positive rates, whereas gestational age at diagnosis and the range of anomalies detected are considered less important in influencing preferences.