Who is and isn't having babies with Down syndrome in western Sydney: a ten year hospital cohort study

Background Screening for Down syndrome (DS) is a key component of antenatal care, recommended to be universally offered to women irrespective of age or background. Despite this, the diagnosis of DS is often not made until the neonatal period. Aims To retrospectively describe and compare the differen...

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Published in:	Australian & New Zealand journal of obstetrics & gynaecology Vol. 57; no. 2; pp. 146 - 151
Main Authors:	Moses, Rebecca M., Brown, James H.W., Wright, Dale C., Diplock, Hayley, Melov, Sarah J., McGee, Therese Mary
Format:	Journal Article
Language:	English
Published:	Australia 01-04-2017
Subjects:	Adult Age Factors antenatal screening Down syndrome Down Syndrome - diagnosis Down Syndrome - epidemiology Female Fetal Diseases - diagnosis Fetal Diseases - epidemiology Humans Infant, Newborn Mass Screening New South Wales - epidemiology Patient Acceptance of Health Care Postpartum Period Practice Patterns, Physicians Prenatal Diagnosis Religion Retrospective Studies trisomy 21 Down syndrome prenatal diagnosis antenatal screening trisomy 21
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Summary:	Background Screening for Down syndrome (DS) is a key component of antenatal care, recommended to be universally offered to women irrespective of age or background. Despite this, the diagnosis of DS is often not made until the neonatal period. Aims To retrospectively describe and compare the differences in populations with an antenatal diagnosis (AD) and neonatal diagnosis (ND) of DS and to explore why an antenatal diagnosis was not made. Materials and methods The cohorts were women cared for at Westmead Hospital whose pregnancy received a diagnosis of DS between 2006 and 2015. The demographic variables of the AD and ND cohorts were examined and reasons why an antenatal diagnosis was not made in the ND cohort were analysed. Results There were 127 diagnoses of DS in the 10‐year period, of which 41% were in the ND cohort (n = 52) and 59% in the AD (n = 75). Declaring a religious affiliation rather than Nil Religion was significantly more common in the ND cohort (88.5%) and especially the ND sub‐cohort who declined DS screening/testing (95.8%) than the AD cohort (72%, P < 0.05). Women who were not offered screening were significantly younger (P < 0.001) than those who were, with 69% and 20% being ≤30 years, respectively. Conclusions The proportion of DS pregnancies diagnosed in the antenatal period in western Sydney could be increased by ensuring younger women are not falsely reassured that DS screening is unnecessary for them. While religious affiliation may be a factor when women decline screening, ensuring appropriate counselling remains important.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0004-8666 1479-828X
DOI:	10.1111/ajo.12617