title: Trends in prenatal screening and diagnostic testing among women referred for advanced maternal age.
abstract: OBJECTIVE
  We evaluated the trends in uptake of amniocentesis and chorionic villi sampling (CVS) for prenatal diagnosis compared with uptake of first and second trimester prenatal serum screening for Down syndrome among patients referred for genetic counseling for advanced maternal age (AMA).
  
  
  METHODS
  Patients referred for AMA genetic counseling from 2001 through 2008 were informed of both prenatal serum screening and invasive diagnostic testing options. Testing offered and testing decisions were entered in a computer database and uptake rates calculated for each year with trends compared using logistic regression analysis.
  
  
  RESULTS
  From 2001 through 2007, we observed a decline in amniocentesis and CVS uptake (p = 0.0001). This trend reversed in 2008 for both invasive procedures (p = 0.0001). Uptake of prenatal serum screening increased over the study period with uptake of first trimester screening increasing 1.7 fold in 2008.
  
  
  CONCLUSIONS
  Improved prenatal screening tests and increased availability of screening for AMA patients has led to a steady decline in uptake of invasive testing from 2001 through 2007. This trend reversed from 2007 through 2008. Possible reasons for this reversal are discussed.
authors.affiliation: Genzyme Genetics, Los Angeles, CA 90066, USA. Naomi.Nakata@genzyme.com
authors.forename: Naomi
authors.initials: N
authors.lastname: Nakata
authors.forename: Yuemei
authors.initials: Y
authors.lastname: Wang
authors.forename: Sucheta
authors.initials: S
authors.lastname: Bhatt
mesh_terms: D000328:Adult; D000649:Amniocentesis / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D015193:Chorionic Villi Sampling / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D004314:Down Syndrome / Q000097:blood* / Q000175:diagnosis; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D008423:Maternal Age; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011262:Pregnancy Trimester, Second / Q000097:blood; D018566:Pregnancy, High-Risk / Q000097:blood*