title: Inequalities in the reported offer and uptake of antenatal screening.
abstract: OBJECTIVE
  The objective of this study was to identify whether there is a different pattern of reported offer and uptake of antenatal screening tests across social groups.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Two large maternity hospitals in Northern Ireland.
  
  
  METHODS
  Women booking for antenatal care were recruited consecutively over a 3-month period commencing 1 September 2003. In total, 711 women were recruited at booking: 359 at Hospital 1 and 352 at Hospital 2. Six hundred and sixty-six women completed both interviews.
  
  
  METHODS
  Two semi-structured interviews were arranged with consenting participants. The first interview was conducted at the booking appointment, and the second interview took place after 23 weeks of gestation after all screening, including anomaly ultrasound, would have been offered.
  
  
  METHODS
  Reported offer and uptake of all screening tests were explored in relation to key sociodemographic indicators: level of education; mother's occupation; partner's occupation; single parent status; car ownership; religious denomination; and Townsend Deprivation Index.
  
  
  RESULTS
  With the exception of screening for Down's syndrome and neural tube defects, virtually all of the women were offered and underwent screening tests. Further analysis of data from Hospital 1 showed that, after controlling for other sociodemographic factors, women with a lower level of education had a lower odds of reporting Down's syndrome screening being offered Down's syndrome screening. Women having private antenatal care had a higher odds of accepting the offer of a test for Down's syndrome.
  
  
  CONCLUSIONS
  While the majority of antenatal screening tests are offered to all pregnant women in Northern Ireland, screening for Down's syndrome and NTD reflects a different pattern of offer and uptake. This paper provides evidence of variations in offer and uptake that exist even when it is hospital policy to offer screening to all women.
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK. f.a.alderdice@qub.ac.uk
authors.forename: Fiona
authors.initials: F
authors.lastname: Alderdice
authors.forename: Jenny
authors.initials: J
authors.lastname: McNeill
authors.forename: Rachel
authors.initials: R
authors.lastname: Rowe
authors.forename: Denis
authors.initials: D
authors.lastname: Martin
authors.forename: Jim
authors.initials: J
authors.lastname: Dornan
mesh_terms: D000328:Adult; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration*; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D044469:Racial Groups; D012959:Socioeconomic Factors