Premium
Factors determining uptake of invasive testing following first‐trimester combined testing
Author(s) -
Lichtenbelt Klaske D.,
SchuringBlom G. Heleen,
Burg N.,
PageChristiaens Godelieve C. M. L.,
Knoers Nine V.,
Schielen Peter C. J. I.,
Koster Maria P. H.
Publication year - 2013
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4067
Subject(s) - medicine , confidence interval , odds ratio , logistic regression , down syndrome , obstetrics , pregnancy , risk assessment , gynecology , multivariate analysis , multivariate statistics , statistics , biology , genetics , computer security , mathematics , psychiatry , computer science
Objective This study aims to analyze differences in characteristics between women who opted for invasive testing after first‐trimester combined testing and those who did not. Method Follow‐up was performed in 20 215 combined tests conducted between 2007 and 2011 in the central region of the Netherlands. Multivariate logistic regression analysis compared variables (Down syndrome risk estimate, maternal age, previous Down syndrome pregnancy, IVF/ICSI, parity and nuchal translucency measurement) between different groups. Results 65.4% of women with a Down syndrome risk estimate ≥1 in 200 opted for invasive 49 testing. In a multivariate model, women opting for invasive testing were significantly younger (odds ratio 0.92; 95% confidence interval 0.88–0.95) and less likely to have had IVF/ICSI (odds ratio 0.57; 95% confidence interval 0.37–0.87) than women opting out on invasive testing. In this high risk group, women <36 years opted for invasive testing more frequently, regardless of their Down syndrome risk estimate magnitude. Women ≥36 years let the magnitude of the risk estimate count significantly in their decision to opt for invasive testing. Conclusion Because of the dissimilarity in the offer of prenatal screening and invasive diagnosis in the Dutch prenatal screening policy, women <36 years and women >36 years make different choices when confronted with similar Down syndrome risk estimates. © 2013 John Wiley & Sons, Ltd.