title: Trends in the utilization of invasive prenatal diagnosis in The Netherlands during 2000-2009.
abstract: OBJECTIVE
  To analyze trends in the number and type of invasive procedure, reasons for referral, maternal age and chromosomal abnormalities over a 10-year period and correlate the trends to changes in the national prenatal screening policy.
  
  
  METHODS
  Data from 10 706 invasive prenatal procedures yielding a full karyotype, performed between 2000 and 2009 were extracted from the cytogenetic database in the central region of The Netherlands. Trends were analyzed.
  
  
  RESULTS
  Over a 10-year period, the number of invasive procedures halved and the percentage of chromosomal abnormalities detected, increased from 5.5 to 9.4%. After 2007, however, 5.7% of karyotypes in women over 36 years were found to be abnormal, versus 18.1% in women below 36 years. In 2009, 71.5% of women over 36 are still referred for invasive prenatal diagnosis on the indication advanced maternal age.
  
  
  CONCLUSIONS
  Changes in prenatal screening policy significantly increased referral after screening and improved the efficacy of invasive prenatal diagnosis. We show the continuing effect of the different policies applied in the past to women below and above the age of 36. To further improve efficacy of invasive prenatal diagnosis, first trimester combination screening should be actively offered to women of all ages.
authors.affiliation: Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands. k.d.lichtenbelt@umcutrecht.nl
authors.forename: Klaske D
authors.initials: KD
authors.lastname: Lichtenbelt
authors.forename: Behrooz Z
authors.initials: BZ
authors.lastname: Alizadeh
authors.forename: Peter G
authors.initials: PG
authors.lastname: Scheffer
authors.forename: Philip
authors.initials: P
authors.lastname: Stoutenbeek
authors.forename: Peter C J I
authors.initials: PC
authors.lastname: Schielen
authors.forename: Lieve C M L
authors.initials: LC
authors.lastname: Page-Christiaens
authors.forename: G Heleen
authors.initials: GH
authors.lastname: Schuring-Blom
mesh_terms: D000328:Adult; D000649:Amniocentesis / Q000706:statistics & numerical data* / Q000639:trends; D015193:Chorionic Villi Sampling / Q000706:statistics & numerical data* / Q000639:trends; D002869:Chromosome Aberrations / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007621:Karyotyping; D008423:Maternal Age; D009426:Netherlands; D011237:Predictive Value of Tests; D011247:Pregnancy