title: Ethnic and socio-economic differences in uptake of prenatal diagnostic tests for Down's syndrome.
abstract: OBJECTIVE
  The objective of this study was to assess ethnic and socio-economic differences in the uptake of maternal age-based prenatal diagnostic testing for Down's syndrome by amniocentesis or chorionic villus sampling.
  
  
  METHODS
  The study population consisted of 12,340 women aged 36 years or over, who lived in a geographically defined region in the Southwest of The Netherlands and who gave birth to a live born infant in the period 2000-2004. Data were obtained from the Department of Clinical Genetics Erasmus MC and Statistics Netherlands. Logistic regression analyses were done to assess ethnic and socio-economic differences in uptake.
  
  
  RESULTS
  The overall uptake of prenatal diagnostic tests was 28.5%. Women of Turkish and Caribbean origin participated in prenatal diagnostic tests equally or more often than Dutch women. Women of North-African origin and women from low socio-economic background had a lower uptake than others. Ethnic differences in uptake could not be attributed to differences in socio-economic background.
  
  
  CONCLUSIONS
  Uptake of prenatal diagnostic tests for Down's syndrome in The Netherlands was low and varied among ethnic and socio-economic groups of advanced maternal age. The finding that women of Turkish and Caribbean origin participated in prenatal diagnostic tests equally or more often than Dutch women was unexpected. The low uptake among Dutch women may be related to the Dutch pregnancy culture. The finding that women of North-African origin and women from low socio-economic background had a lower uptake may be related to barriers in access to prenatal diagnostic tests.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands. m.fransen@erasmusmc.nl
authors.forename: Mirjam P
authors.initials: MP
authors.lastname: Fransen
authors.forename: Hajo I J
authors.initials: HI
authors.lastname: Wildschut
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: Galjaard
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
mesh_terms: D000649:Amniocentesis / Q000523:psychology; D015193:Chorionic Villi Sampling / Q000523:psychology; D004314:Down Syndrome / Q000175:diagnosis*; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D015999:Multivariate Analysis; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000523:psychology*; D012189:Retrospective Studies; D012959:Socioeconomic Factors