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Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study

BACKGROUND: Two prenatal screening tests for congenital anomalies are offered to all pregnant women in the Netherlands on an opt-in basis: the Combined Test (CT) for Down syndrome at twelve weeks, and the Fetal Anomaly Scan (FAS) at around twenty weeks. The CT is free for women who are 36 or older;...

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Autores principales: Gitsels - van der Wal, Janneke T, Verhoeven, Pieternel S, Manniën, Judith, Martin, Linda, Reinders, Hans S, Spelten, Evelien, Hutton, Eileen K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137078/
https://www.ncbi.nlm.nih.gov/pubmed/25106057
http://dx.doi.org/10.1186/1471-2393-14-264
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author Gitsels - van der Wal, Janneke T
Verhoeven, Pieternel S
Manniën, Judith
Martin, Linda
Reinders, Hans S
Spelten, Evelien
Hutton, Eileen K
author_facet Gitsels - van der Wal, Janneke T
Verhoeven, Pieternel S
Manniën, Judith
Martin, Linda
Reinders, Hans S
Spelten, Evelien
Hutton, Eileen K
author_sort Gitsels - van der Wal, Janneke T
collection PubMed
description BACKGROUND: Two prenatal screening tests for congenital anomalies are offered to all pregnant women in the Netherlands on an opt-in basis: the Combined Test (CT) for Down syndrome at twelve weeks, and the Fetal Anomaly Scan (FAS) at around twenty weeks. The CT is free for women who are 36 or older; the FAS is free for all women. We investigated factors associated with the CT and FAS uptake. METHOD: This study is part of the DELIVER study that evaluated primary care midwifery in the Netherlands. Associations between the women’s characteristics and the CT and FAS uptake were measured using multivariate and multilevel logistic regression analyses. RESULTS: Of 5216 participants, 23% had the CT and 90% had the FAS, with uptake rates ranging from 4% to 48% and 62% to 98% respectively between practices. Age (OR: 2.71), income (OR: 1.38), ethnicity (OR: 1.37), being Protestant (OR: 0.25), multiparous (OR: 0.64) and living in the east of the country (OR: 0.31) were associated with CT uptake; education (OR: 1.26), income (OR: 1.66), being Protestant (OR: 0.37) or Muslim (OR: 0.31) and being multiparous (OR: 0.74) were associated with FAS uptake. Among western women with a non-Dutch background, first generation (OR: 2.91), age (OR: 2.00), income (OR: 1.97), being Protestant (OR: 0.32) and living in the east (OR: 0.44) were associated with CT uptake; being Catholic (OR: 0.27), Protestant (OR: 0.13) were associated with FAS uptake. Among non- western women with a non-Dutch background, age (OR: 1.73), income (OR: 1.97) and lacking proficiency in Dutch (OR: 2.18) were associated with CT uptake; higher education (OR: 1.47), being Muslim (OR: 0.37) and first generation (OR: 0.27) were associated with FAS uptake. CONCLUSION: The uptake of the CT and FAS varied widely between practices. Income, parity and being Protestant were associated with uptake of both tests; ethnicity, age and living in the east were associated with CT uptake, and education and being Muslim with FAS uptake. These findings help to explain some differences between women choosing or declining early and late screening, but not the large variation in test uptake among practices, nor between the Netherlands and other countries.
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spelling pubmed-41370782014-08-19 Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study Gitsels - van der Wal, Janneke T Verhoeven, Pieternel S Manniën, Judith Martin, Linda Reinders, Hans S Spelten, Evelien Hutton, Eileen K BMC Pregnancy Childbirth Research Article BACKGROUND: Two prenatal screening tests for congenital anomalies are offered to all pregnant women in the Netherlands on an opt-in basis: the Combined Test (CT) for Down syndrome at twelve weeks, and the Fetal Anomaly Scan (FAS) at around twenty weeks. The CT is free for women who are 36 or older; the FAS is free for all women. We investigated factors associated with the CT and FAS uptake. METHOD: This study is part of the DELIVER study that evaluated primary care midwifery in the Netherlands. Associations between the women’s characteristics and the CT and FAS uptake were measured using multivariate and multilevel logistic regression analyses. RESULTS: Of 5216 participants, 23% had the CT and 90% had the FAS, with uptake rates ranging from 4% to 48% and 62% to 98% respectively between practices. Age (OR: 2.71), income (OR: 1.38), ethnicity (OR: 1.37), being Protestant (OR: 0.25), multiparous (OR: 0.64) and living in the east of the country (OR: 0.31) were associated with CT uptake; education (OR: 1.26), income (OR: 1.66), being Protestant (OR: 0.37) or Muslim (OR: 0.31) and being multiparous (OR: 0.74) were associated with FAS uptake. Among western women with a non-Dutch background, first generation (OR: 2.91), age (OR: 2.00), income (OR: 1.97), being Protestant (OR: 0.32) and living in the east (OR: 0.44) were associated with CT uptake; being Catholic (OR: 0.27), Protestant (OR: 0.13) were associated with FAS uptake. Among non- western women with a non-Dutch background, age (OR: 1.73), income (OR: 1.97) and lacking proficiency in Dutch (OR: 2.18) were associated with CT uptake; higher education (OR: 1.47), being Muslim (OR: 0.37) and first generation (OR: 0.27) were associated with FAS uptake. CONCLUSION: The uptake of the CT and FAS varied widely between practices. Income, parity and being Protestant were associated with uptake of both tests; ethnicity, age and living in the east were associated with CT uptake, and education and being Muslim with FAS uptake. These findings help to explain some differences between women choosing or declining early and late screening, but not the large variation in test uptake among practices, nor between the Netherlands and other countries. BioMed Central 2014-08-09 /pmc/articles/PMC4137078/ /pubmed/25106057 http://dx.doi.org/10.1186/1471-2393-14-264 Text en © Gitsels - van der Wal et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Gitsels - van der Wal, Janneke T
Verhoeven, Pieternel S
Manniën, Judith
Martin, Linda
Reinders, Hans S
Spelten, Evelien
Hutton, Eileen K
Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study
title Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study
title_full Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study
title_fullStr Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study
title_full_unstemmed Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study
title_short Factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study
title_sort factors affecting the uptake of prenatal screening tests for congenital anomalies; a multicentre prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137078/
https://www.ncbi.nlm.nih.gov/pubmed/25106057
http://dx.doi.org/10.1186/1471-2393-14-264
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