A systematic review of issues around antenatal screening and prenatal diagnostic testing for genetic disorders: women of Asian origin in western countries

Abstract

Antenatal screening has become standard practice in many countries. However, not all pregnant women choose to be tested. In the UK, the incidence of some birth defects is found to be higher in babies of Asian women than in those of women from other ethnic groups, while there is some evidence suggesting that ethnic minorities, especially Asian women, are less likely to undergo antenatal screening and prenatal diagnosis, the reasons for which are unclear. This study aims to identify and describe the literature on issues around antenatal screening and prenatal diagnostic testing for genetic disorders among women of Asian descent in western countries. The Medline, CINAHL, ASSIA and PsycInfo databases were searched for the period of 1995 and 2010. Twenty‐one studies met the inclusion criteria and were therefore reviewed. In general, Asian women were found to hold favourable attitudes towards testing. However, they reported a poorer understanding of testing than white women and not being offered a test, and were less able to make informed choices. Asian women in the UK and Australia were found to be less likely than their white counterparts to have undergone prenatal diagnosis, while such differences were not found in the USA and Canada. The equity of access to quality antenatal care, alongside comprehensive well thought out antenatal screening programmes, can be assured if strategies are in place which actively involve all ethnic groups and take account of social and cultural appropriateness for the population served. An understanding of broad factors that inform women’s decision‐making on test uptake would help health professionals provide women and their families with more culturally sensitive information and support that they may additionally need to make more informed choices.

Preferences for prenatal tests for Down syndrome: an international comparison of the views of pregnant women and health professionals

“…There is some evidence suggesting ethnic minority groups in Western countries differ in how they view and use prenatal screening and testing. [32][33][34] Further research is needed to determine whether these differences include attitudes to NIPT and, if so, how these could be addressed to improve service delivery in increasingly multicultural societies.…”

Determinants of first trimester combined test participation within the central region of the Netherlands

“…ethnicity and religion) and individual factors (e.g. maternal age and parity) appear to play an important role in utilisation of FCT . Therefore, we designed a study to investigate the association between potential influential determinants on uptake rates within the central region of the Netherlands.…”

Prenatal screening for congenital anomalies: exploring midwives’ perceptions of counseling clients with religious backgrounds

“…Different roles are presented in this model; medical technical expert, advisor and teacher, and counselor in case of exploring values and supporting decision making. The MIMES model identified a number of factors that are relevant in test uptake decisions, including not only well-known factors such as age, parity, family life and personal experience, but also ‘identity markers’ such as ethnicity and religion [10-14]. It is acknowledged that the difficult questions that confront clients in decision-making may be influenced by their religious convictions [15-18].…”