[Socioeconomic disparities for maternal serum screening of Down's syndrome: trends between 1998 and 2003 in France].

J Gynecol Obstet Biol Reprod (Paris)

INSERM, UMR S149, IFR 69, unité de recherches épidémiologiques en santé périnatale et santé des femmes, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France.

Published: May 2008

Objectives: To compare trends in the use of and the opportunity for making an informed choice, regarding maternal serum screening for Down's syndrome.

Methods: Data were based on the national perinatal surveys of 1998 and 2003, which comprise representative samples of births in France. We used logistic regression models and likelihood ratio tests for testing the statistical significance of interactions between time trends and socioeconomic factors.

Results: We found a generalized increase between 1998 and 2003 in both the use of screening and in the opportunity for making an informed choice. The use of screening increased more however, for women with primary or no education (OR=3.0; 95% CI, 2.2-4.1) as compared with those with education levels beyond a high school diploma (OR: 1.8; 95% CI, 1.7-2.0). On the contrary, trends in informed choice were comparable across socioeconomic groups. Hence, disparities in the opportunity for informed choice were essentially unchanged.

Conclusions: The use of serum screening, and the opportunity for informed choice regarding the test, became more widespread for women from all socioeconomic categories between 1998 and 2003. These trends were accompanied by a decrease in socioeconomic disparities in the use of screening but not in the opportunity for making an informed choice.

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http://dx.doi.org/10.1016/j.jgyn.2007.12.006DOI Listing

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