title: [Health Council of Netherlands recommendation 'Serum screening for risk assessment of Down syndrome for all women' poorly supported].
abstract: The Health Council of the Netherlands has recommended a new policy of offering triple test-based serum screening for Down's syndrome to all pregnant women rather than the current policy of maternal age-based screening for pregnant women aged 36 years and above. In these older pregnant women, this risk-assessment serum screening would indeed prevent many miscarriages caused by the invasive procedure. However, in pregnant women under 30 years of age this policy would imply the need to counsel almost 80,000 young pregnant women each year, and the need to perform 2,200 invasive procedures in order to detect 29 Down's syndrome cases, while 45 cases would still remain undetected. Moreover, as only 11% of the detectable Down's syndrome cases are found in women under 30, it would appear advisable to only offer the risk-assessment serum screening to pregnant women aged 30 years and above.
authors.affiliation: Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Verloskunde/Gynaecologie, Postbus 22.700, 1100 DE Amsterdam. j.v.hamerlynck@amc.uva.nl
authors.forename: J V
authors.initials: JV
authors.lastname: Hamerlynck
authors.forename: M
authors.initials: M
authors.lastname: Knuist
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000649:Amniocentesis / Q000009:adverse effects; D006063:Chorionic Gonadotropin / Q000097:blood*; D004314:Down Syndrome / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D004964:Estriol / Q000097:blood*; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000592:standards*; D009426:Netherlands / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000592:standards*; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins; D004964:Estriol