Screening options for Down syndrome: how women choose in real clinical setting.
OBJECTIVE
To study pregnant women's preference among various screening options for Down syndrome (DS) in routine clinical setting, and its potential association with women's demographic characteristics.


METHODS
Women aged 35 years and older carrying singleton pregnancy were offered a variety of screening tests for DS before 14 weeks of gestation. Their preference was confirmed by the test they actually underwent. The association between women's choice of test and a number of demographic characteristics was studied using multinomial regression.


RESULTS
Among 1967 eligible women, 619 opted for first-trimester screening test (FTS), 924 for partial integrated test (PIT), and 424 for full integrated test (FIT). Nulliparous women and working mothers were more likely to choose FTS and FIT. Women with history of subfertility were more likely to choose FIT. Women with family history of chromosomal abnormalities were more likely to choose FTS. The choice of screening test could be predicted for 49.9% of women using four demographic characteristics.


CONCLUSIONS
Among older women of predominantly Chinese ethnicity, integrated test is a favorite alternative to FTS. Their choice of DS screening test can be predicted by their obstetric and socioeconomic characteristics. Many women show willingness to pay for a test with a lower false-positive rate.
Prenatal Diagnosis and Counselling Unit, Department of Obstetrics and Gynecology, Kwong Wah Hospital, Kowloon West Cluster, HKSAR, China. a9401438@graduate.hku.hk
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D000328:Adult; D004314:Down Syndrome / Q000175:diagnosis*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods / Q000523:psychology; D008423:Maternal Age; D008875:Middle Aged; D057240:Patient Preference / Q000191:economics / Q000706:statistics & numerical data; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis / Q000191:economics / Q000379:methods* / Q000523:psychology; D018456:Reproductive Medicine; D012959:Socioeconomic Factors