Comparison of the use of amniocentesis in two countries with different policies for prenatal testing: the case of France and the United States.
OBJECTIVE
To compare maternal age- and education-specific use of amniocentesis in France and the United States.


METHODS
We used two nationally representative datasets, National Perinatal Survey of 1998 in France (n = 12 816) and National Center for Health Statistics birth data for 1997 in the United States (n = 3 799 975). Analyses included binomial regression with test of interactions between country, maternal age and education.


RESULTS
Amniocentesis use was more than threefold greater in France than in the United States (Risk Ratio (RR) 3.2, 95% CI, 3.1-3.4). This was true across maternal age and education groups. Differences in use of amniocentesis were greatest, however, for women with lower levels of education and older (>/=38 years) women.


CONCLUSIONS
Our results suggest greater use and lesser disparities in maternal age- and education-specific use of amniocentesis in France as compared to that in the United States. These differences may be due to several factors, including differences in women's cultural values and preferences. They may also represent barriers to effective access to prenatal testing, particularly for women in lower socioeconomic groups, in the United States.
Khoshnood
Babak
B
Epidemiological Research Unit on Perinatal and Women's Health, INSERM U149, France. khoshmood@vjf.inserm.fr
Blondel
Béatrice
B
Bréart
Gérard
G
Lee
Kwang-sun
KS
Pryde
Peter
P
Schoendorf
Kenneth
K
D000649:Amniocentesis / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005602:France; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D012923:Social Class; D014481:United States