Format

Send to:

Choose Destination
See comment in PubMed Commons below
Prenat Diagn. 2002 Dec;22(13):1195-200.

Preference assessment of prenatal diagnosis for Down syndrome: is 35 years a rational cutoff?

Author information

  • 1Sections of Maternal-Fetal Medicine and Reproductive Genetics, Northwestern University Medical School Institute for Social Research and Health Policy Studies, Northwestern University, Chicago, Illinois, USA. w-grobman@northwestern.edu

Abstract

OBJECTIVE:

To compare the perceptions of miscarriage and birth of a child with Down syndrome among pregnant women and to evaluate the implications of these preferences for the traditional 35-year old maternal age risk boundary.

METHODS:

An interviewer-administered survey was given to 186 pregnant women receiving antepartum care at a university hospital. Preferences, as reflected by utilities, for birth of a child with Down syndrome and pregnancy miscarriage, stratified by patient characteristics, were assessed.

RESULTS:

The utility for the birth of a child with Down syndrome decreased (p < 0.001) as clinical severity increased from mild (0.78) to severe (0.65). Miscarriage of a pregnancy had a mean utility of 0.76 +/- 0.31. Women who desired prenatal diagnosis had a utility value for miscarriage (0.79 +/- 0.28) that was significantly higher than for the birth of a child with Down syndrome of unknown severity (0.73 +/- 0.27). In multivariable logistic regression, desire for prenatal diagnosis was the only factor associated with a preference of miscarriage over birth of an affected child (odds ratio 2.26, 95% confidence interval 1.03, 4.96).

CONCLUSION:

Women who desire prenatal diagnosis do not perceive the birth of a child with Down syndrome and a pregnancy miscarriage to be equivalent health states. This finding calls into question the rationale of the 35-year-old maternal age criterion and suggests that actual patient preferences should be better incorporated into the decision to offer definitive prenatal diagnosis.

Copyright 2002 John Wiley & Sons, Ltd.

PMID:
12478632
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for John Wiley & Sons, Inc.
    Loading ...
    Write to the Help Desk