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Am J Public Health. 2006 Dec;96(12):2139-44. Epub 2006 Oct 31.

Advances in medical technology and creation of disparities: the case of Down syndrome.

Author information

  • 1Unit on Perinatal and Women's Health, Institut National de la Santé et de la Recherche Médicale (INSERM), U149, Paris, France. khoshnood@vjf.inserm.fr

Abstract

OBJECTIVES:

We assessed socioeconomic differences in probabilities of prenatal diagnoses of Down syndrome and continuation of pregnancies after such diagnoses, along with the effects of these differences on disparities in live-birth prevalences of Down syndrome.

METHODS:

Using population-based data derived from 1433 cases of Down syndrome and 3731 control births, we assessed age-adjusted effects of maternal occupation and geographic origin on prenatal diagnoses, as well as overall and live-birth odds, of Down syndrome.

RESULTS:

Maternal occupation and geographic origin had significant effects on the probability of a prenatal diagnosis of Down syndrome and on continuation of pregnancy after such a diagnosis. Women in lower-status occupational categories had higher odds of delivering a live-born infant with Down syndrome. In comparison with women in the highest-status occupational category, the age-adjusted odds ratio for a Down syndrome live birth among women without an occupation was 2.4 (95% confidence interval [CI] = 1.7, 3.3). By contrast, there were no disparities in age-adjusted overall likelihood of Down syndrome.

CONCLUSIONS:

Socioeconomic differences in use of prenatal testing have created disparities in the live-birth prevalence of Down syndrome. Overall Down syndrome risk does not vary according to socioeconomic status.

PMID:
17077393
[PubMed - indexed for MEDLINE]
PMCID:
PMC1698165
Free PMC Article
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