title: The relationship between utilization of prenatal care and Down syndrome live births.
abstract: OBJECTIVE
  This study evaluated whether utilization of prenatal care, as measured by the Kessner index, affects the number of Down syndrome live births.
  
  
  METHODS
  A retrospective analysis of birth certificate data of Down syndrome live births comparing 1989 to 2001 by year, maternal age, gestational age at first prenatal visit, and adequacy of prenatal care according to Kessner categories of adequacy of prenatal care.
  
  
  RESULTS
  Down syndrome live births were inversely correlated with adequacy of prenatal care. Reductions in Down syndrome live births were seen in all categories of prenatal care in all age groups. In 2001 a minimum 30% reduction was seen in any category rising to a 58% reduction in women > or =35 years with adequate prenatal care. The largest reductions were seen in women > or =35 years of age.
  
  
  CONCLUSIONS
  Reductions in Down syndrome live births occurred in all age groups between 1989 and 2001. Utilization of prenatal care as measured by the Kessner index was associated with reductions in Down syndrome live births, with a greater reduction in women > or =35 years of age.
authors: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Connecticut School of Medicine, Farmington, CT 06030-2946, USA. bmorris@exchange.uchc.edu
authors: Bruce A
authors: BA
authors: Morris
authors: James F X
authors: JF
authors: Egan
authors: Yu Ming Victor
authors: YM
authors: Fang
authors: Winston A
authors: WA
authors: Campbell
mesh_terms: D000293:Adolescent; D000328:Adult; D016208:Databases, Factual; D004314:Down Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005865:Gestational Age; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008499:Medical Records; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology