Nuchal translucency screening: how do women actually utilize the results?
OBJECTIVE
To examine how women use the nuchal translucency (NT) risk adjustment in decision-making for invasive prenatal diagnosis.


METHODS
Retrospective cohort study of 1083 consecutive NT screening exams. A screen-positive test was defined as a risk > or = 1/300. Primary outcome was what proportion of screen-positive or screen-negative women chose to undergo chorionic villus sampling or amniocentesis.


RESULTS
Of the women tested, 79% (858/1083) were > or = 35-years-old and 88% (756/858) of these women had a decrease in age-related risk after NT. Of the screen-negative women, 31% (238/756) > or = 35 years of age chose to have invasive testing as compared to only 11.2% (25/223) of those < 35 years of age (p < 0.001). Of the screen-positive women, 71% (72/102) > or = 35 years of age and 100% (2/2) < 35 years of age chose to obtain invasive testing (p = 0.368).


CONCLUSIONS
First-trimester NT screening for Down syndrome (DS) enables a significant number of women over age 35 to lower the risk for DS several fold and avoid the risks of invasive testing. However, despite significant reductions in age-specific mid-trimester DS risks, a relatively high proportion of women > or = 35 years of age still opted for invasive testing.
Caughey
Aaron B
AB
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA 94143, USA. abcmd@berkeley.edu
Musci
Thomas J
TJ
Belluomini
Jenny
J
Main
Denise
D
Otto
Carl
C
Goldberg
James
J
D000328:Adult; D000649:Amniocentesis; D002755:Choice Behavior; D015193:Chorionic Villi Sampling; D015331:Cohort Studies; D004314:Down Syndrome / Q000175:diagnosis*; D005260:Female; D006801:Humans; D048208:Nuchal Translucency Measurement / Q000523:psychology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D012307:Risk Factors