title: Maternal age-based prenatal screening for chromosomal disorders: attitudes of women and health care providers toward changes.
abstract: OBJECTIVE
  To explore views of women and health care providers (HCPs) about the changing recommendations regarding maternal age-based prenatal screening.
  
  
  METHODS
  Mixed-methods design.
  
  
  METHODS
  Ontario.
  
  
  METHODS
  A sample of women who had given birth within the previous 2 years and who had attended a family medicine centre, midwifery practice, or baby and mother wellness program (n = 42); and a random sample of family physicians (n = 1600), and all Ontario obstetricians (n = 694) and midwives (n = 334) who provided prenatal care.
  
  
  METHODS
  We used focus groups (FGs) to explore women's views. Content analysis was used to uncover themes and delineate meaning. To explore HCPs' views, we conducted a cross-sectional self-completion survey.
  
  
  RESULTS
  All FG participants (42 women in 6 FGs) expressed the importance of individual choice of prenatal screening modality, regardless of age. They described their perception that society considers women older than 35 to be at high obstetric risk and raised concerns that change in the maternal age-related screening policy would require education. The HCP survey response rate was 40%. Results showed 24% of HCPs agreed that women of any age should be eligible for invasive diagnostic testing regardless of prenatal screening results; 15% agreed that the age for diagnostic testing should be increased to 40 years, 14% agreed that diagnostic testing should be reserved for women with positive prenatal screening results, and 45% agreed that prenatal screening should remain unchanged.
  
  
  CONCLUSIONS
  Maternity care organizations have recommended that maternal age-based prenatal screening is no longer appropriate. Informed choice is of paramount importance to women and should be part of any change. Health care providers need to be engaged in and educated about any change to screening guidelines to offer women informed choices.
authors: Granovsky Gluskin Family Medicine Centre, 60 Murray St, 4th Floor, Box 25, Toronto, ON M5T 3L9. jcarroll@mtsinai.on.ca
authors: June C
authors: JC
authors: Carroll
authors: Andrea
authors: A
authors: Rideout
authors: Brenda J
authors: BJ
authors: Wilson
authors: Judith
authors: J
authors: Allanson
authors: Sean
authors: S
authors: Blaine
authors: Mary Jane
authors: MJ
authors: Esplen
authors: Sandra
authors: S
authors: Farrell
authors: Gail E
authors: GE
authors: Graham
authors: Jennifer
authors: J
authors: MacKenzie
authors: Wendy S
authors: WS
authors: Meschino
authors: Preeti
authors: P
authors: Prakash
authors: Cheryl
authors: C
authors: Shuman
authors: Sherry
authors: S
authors: Taylor
authors: Stasey
authors: S
authors: Tobin
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D025063:Chromosome Disorders / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000379:methods; D005260:Female; D017144:Focus Groups; D005820:Genetic Testing / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D008880:Midwifery / Q000379:methods; D009774:Obstetrics / Q000379:methods; D057240:Patient Preference; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult