Mapping uptake of prenatal diagnosis for Down syndrome and other chromosome abnormalities across Victoria, Australia

Abstract

Geographical differences influence uptake of prenatal diagnosis, probably related to access to services. However, other maternal demographic factors also play a role in uptake. To ensure equity in access and autonomy in women's reproductive choices, reasons for exceptionally low uptake in certain localities or within certain subgroups of pregnant women should be investigated further, followed by appropriate changes in service provision.

Rates of prenatal screening across health care regions in Ontario, Canada: a retrospective cohort study

“…The association between low screening rates and living in remote areas is consistent with findings from other populationbased studies 28,31,32 and from survey reports of reduced rates of offered screening among rural providers. [21][22][23]25 Reasons associated with low rates of offered screening included maternal age less than 35 years, lack of relevant family history and lack of patient request.…”

“…17,20,26,[28][29][30][31][32] We categorized maternal age at delivery or abortion into 3 groups (≤ 20 yr, 21-34 yr or ≥ 35 yr). 28 We linked all women to previous hospital admissions for delivery to determine maternal age at the time of first childbirth (≤ 20 yr, 21-34 yr or ≥ 35 yr).…”

“…[26][27][28][29][30][31][32] In light of the shifting and increasingly market-driven landscape of prenatal screening in Canada, 33 we examined the screening rates for publicly insured tests across health care regions in the province of Ontario. We also determined maternal, provider and regional factors associated with screening uptake.…”

Socio-demographic disparities in the uptake of prenatal screening and diagnosis in Western Australia

“…8,11,[22][23][24][25][26][27][28][29][30][31] A previous Australian study on the uptake of prenatal diagnostic testing in the absence of a screening programme reported lower uptake in rural women, women with three or more children and among Asian women. Higher uptake was observed for those women who gave birth in private hospitals, a surrogate indicator of higher socio-economic status.…”

Long‐term trends for socio‐economic differences in prenatal diagnosis of Down syndrome: diffusion of services or persistence of disparities?

“…Few studies [15][16][17] have assessed the impact of differences in the use of prenatal testing modalities on disparities in the proportions of Down syndrome cases that are actually diagnosed prenatally. Moreover, to our knowledge, none of the previous studies has examined population-based, long-term trends for disparities in the probability of prenatal diagnosis of Down syndrome.…”