title: Ethnic differences in participation in prenatal screening for Down syndrome: a register-based study.
abstract: OBJECTIVE
  To assess ethnic differences in participation in prenatal screening for Down syndrome in the Netherlands.
  
  
  METHODS
  Participation in prenatal screening was assessed for the period 1 January 2009 to 1 July 2009 in a defined postal code area in the southwest of the Netherlands. Data on ethnic origin, socio-economic background and age of participants in prenatal screening were obtained from the Medical Diagnostic Centre and the Department of Clinical Genetics. Population data were obtained from Statistics Netherlands. Logistic regression models were used to assess ethnic differences in participation, adjusted for socio-economic and age differences.
  
  
  RESULTS
  The overall participation in prenatal screening was 3865 out of 15 093 (26%). Participation was 28% among Dutch women, 15% among those from Turkish ethnic origin, 8% among those from North-African origin, 15% among those from Aruban/Antillean origin and 26% among women from Surinamese origin.
  
  
  CONCLUSIONS
  Compared to Dutch women, those from Turkish, North-African, Aruban/Antillean and other non-Western ethnic origin were less likely to participate in screening. It was unexpected that women from Surinamese origin equally participated. It should be further investigated to what extent participation and non-participation in these various ethnic groups was based on informed decision-making.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. m.fransen@erasmusmc.nl
authors.forename: Mirjam P
authors.initials: MP
authors.lastname: Fransen
authors.forename: Marleen H M H J D
authors.initials: MH
authors.lastname: Schoonen
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Harry J
authors.initials: HJ
authors.lastname: de Koning
authors.forename: Jacqueline A M
authors.initials: JA
authors.lastname: Laudy
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: Galjaard
authors.forename: Caspar W N
authors.initials: CW
authors.lastname: Looman
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
authors.forename: Hajo I J
authors.initials: HI
authors.lastname: Wildschut
mesh_terms: D000328:Adult; D001294:Attitude to Health; D004314:Down Syndrome / Q000175:diagnosis* / Q000208:ethnology*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005817:Genetic Counseling / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008423:Maternal Age; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D012042:Registries; D012959:Socioeconomic Factors