[Influencing factors of utilization of prenatal screening for Down's syndrome].
OBJECTIVE
To describe the pregnant women's utilization of prenatal screening for Down's syndrome and its influencing factors.


METHODS
From October 2007 to December 2008, 4250 lying-in women in 54 hospitals were surveyed by stratified cluster sampling method in Zhejiang, Hunan and Sichuan, which located in Eastern, Central and Western China, respectively. Demographic characteristics, knowledge and health behaviors were collected by the questionnaire of lying-in women's utilization and influencing factors of prenatal screening for Down's syndrome. Whether to use prenatal screening was determined by the lying-in women's medical history. Chi-square test and logistic regression analysis were used to analyze data.


RESULTS
Respondents' age was (26.92 ± 4.60) years old. The total utilization rate of prenatal screening for Down's syndrome was 40.0% (1696/4237), and screening utilization rates in Zhejiang, Hunan and Sichuan were 48.23% (682/1414), 41.73% (616/1476) and 29.55% (398/1347), respectively. Screening utilization rates of respondents with college degree or above and high school or below were 72.68% (697/959) and 30.46% (998/3276), respectively. Screening utilization rates of urban and rural respondents were 63.00% (952/1511) and 27.11% (732/2700), respectively. Screening utilization rates of respondents under 35 years old and over 35 years old were 41.40% (1645/3973) and 19.32% (51/264). All differences were significant (all P values < 0.05). A total of 79.14% (1419/1793) of respondents thought it was necessary to take prenatal screening for Down's syndrome, and 79.47% (1506/1895) of respondents received doctors' suggestions, 24.2% (654/2702) of respondents who heard of prenatal screening for Down's syndrome could figure out the main pathogenic factors, while 23.0% (621/2702) didn't know any factors; 77.8% (2102/2702) of respondents heard of prenatal screening for Down's syndrome, but 12.3% (259/2102) didn't know the appropriate gestational weeks to uptake the screening, 47.0% (988/2102) knew of prenatal screening for Down's syndrome through healthcare providers. Logistic regression analysis result demonstrated that living in Zhejiang (OR = 1.62, 95%CI: 1.26 - 2.08), city residence (OR = 2.06, 95%CI: 1.63 - 2.60), with positive attitude to screening (OR = 5.00, 95%CI: 3.97 - 6.29), pregnant women's age below 35 years old (OR = 3.86, 95%CI: 2.53 - 5.89), receiving advices from healthcare providers (OR = 12.64, 95.0%CI: 9.97 - 16.02), college degree or above educational level (OR = 2.67, 95%CI: 2.03 - 3.50) were facilitating factors on utilization of prenatal screening for Down's Syndrome.


CONCLUSIONS
Pregnant women's use of prenatal screening for Down's syndrome was not enough, and living in zhejiang, higher education level, rural respondents with age under 35 years old, receiving advice from healthcare providers or not and their attitude toward necessity were significant promotive factors of utilization of prenatal screening for Down's syndrome.
Department of Hospital Management, School of Public Health, Fudan University, Shanghai 200032, China.
Er-zhou
EZ
Gu
Qian
Q
Gu
Peng
P
Han
Dan
D
Tian
Ying-yao
YY
Chen
D000328:Adult; D002681:China; D004314:Down Syndrome / Q000517:prevention & control*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods* / Q000706:statistics & numerical data*; D055815:Young Adult