Socioeconomic barriers to informed decisionmaking regarding maternal serum screening for down syndrome: results of the French National Perinatal Survey of 1998.
OBJECTIVE
We sought to evaluate socioeconomic disparities in serum screening for Down syndrome and assess whether such disparities are more likely to reflect limits in access or information or, rather, informed decisionmaking.


METHODS
A nationally representative sample of 12 869 French women completed interviews after giving birth.


RESULTS
We found substantial disparities in the likelihood of (1) women not being offered screening, (2) screening not being offered as a result of late prenatal care, and (3) women not knowing whether or not they had undergone screening. Except in the case of nationality, there was essentially no evidence of differences in refusal of testing.


CONCLUSIONS
Rather than representing informed decisionmaking, socioeconomic disparities in screening for Down syndrome are mostly due to limits in access or to information.
L'Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France. khoshnood@vif.inserm.fr
Babak
B
Khoshnood
Béatrice
B
Blondel
Catherine
C
de Vigan
Gérard
G
Bréart
D000328:Adult; D003657:Decision Making; D004314:Down Syndrome / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D005602:France; D005820:Genetic Testing / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008423:Maternal Age; D008499:Medical Records; D009313:National Health Programs; D010353:Patient Education as Topic; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012935:Social Justice; D012959:Socioeconomic Factors