Does women\u2019s place of birth affect their opportunity for an informed choice about Down syndrome screening? A population-based study in France

O Anselem ,Babak Khoshnood ,Priscille Sauvegrain ,Marie‐Josèphe Saurel‐Cubizolles ,Béatrice Blondel ,Nathalie Bertille ,Élie Azria

doi:10.1186/s12884-021-04041-8

Abstract

BackgroundTo examine disparities by maternal place of birth in the opportunity to make an informed choice about Down syndrome screening, in France, where the national guidelines recommend that physicians offer it to all pregnant women.MethodsWe used population-based data from the nationally representative French Perinatal Surveys in 2010 and 2016 (N=24,644 women) to analyze the opportunity for an informed choice for prenatal screening, measured by a composite indicator.ResultsAmong the 24 644 women in the study, 20 612 (83.6%) were born in France, 861 (3.5%) elsewhere in Europe, 1550 (6.3%) in North Africa, and 960 (3.9%) in sub-Saharan Africa. The probability of screening was lower for women born outside France. After adjustment for survey year, maternal age, parity, education level, and the maternity unit’s level of perinatal care, women born outside France had the opportunity to make an informed choice less often than women born in France. This association remained essentially the same even after excluding women without adequate prenatal care.ConclusionsWomen born outside France, including those with adequate prenatal care, had less opportunity than women born in France to make an informed choice about prenatal screening for Down syndrome.

Highlights

To examine disparities by maternal place of birth in the opportunity to make an informed choice about Down syndrome screening, in France, where the national guidelines recommend that physicians offer it to all pregnant women
We considered that women had not had this opportunity when they answered “I don’t know” to the question "Did you have a blood test to learn your risk for Down syndrome?", based on the hypothesis that women who did not remember having this test had not received sufficient information to make an informed choice
Prenatal screening for Down syndrome, whether by nuchal translucency measurements or maternal serum marker assays, rose significantly between 2010 and 2016 (p

Summary

Introduction

To examine disparities by maternal place of birth in the opportunity to make an informed choice about Down syndrome screening, in France, where the national guidelines recommend that physicians offer it to all pregnant women. HAS currently recommends that physicians inform all women that nuchal translucency can be measured at the first ultrasound examination, between 11 weeks and 13 weeks +6 days, and that they can have blood tests. These results enable a risk calculation that integrates the maternal serum markers and can be assayed during the first or second trimester [2].

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