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

Abstract

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.

Association between timing of diagnosis of trisomy 21, 18, and 13 and maternal socio‐economic status in Victoria, Australia: A population‐based cohort study from 2015 to 2016

“…Sociodemographic factors such as income, education, maternal age, rurality, and ethnicity significantly influence whether women are offered or utilise prenatal screening tests in the first instance . We found that the likelihood of a live birth with T21 was almost five times as high in the most disadvantaged women compared with the least and the majority of these women had not utilised any prenatal screening.…”

A clinical audit of combined first trimester screening and non‐invasive prenatal testing offered to pregnant women in a regional Australian hospital

“…More recently, a study from Western Sydney compared women who had a diagnosis of Down syndrome made antenatally with those whose diagnosis was made in the neonate; 25% of women in whom the diagnosis was made after birth had not been offered screening despite attending their GPs in the first trimester, or the hospital antenatal clinic, where second trimester serum screening is offered free of charge. Nearly 70% of these women not offered screening were aged <30 years, compared to just 20% of those who were offered screening.…”

“…Current programs in Australia use combined first trimester screening (CFTS) which includes maternal age, ultrasound measurement of fetal nuchal translucency and sometimes other markers, and maternal serum marker levels (β human chorionic gonadotropin plus pregnancy‐associated plasma protein A) to provide an overall risk for trisomy 21 and other aneuploidies . Second trimester triple serum screening (STSS) is available free of charge in certain hospitals when a woman has booked too late for CFTS . Non‐invasive prenatal screening (NIPT) using cell‐free fetal DNA (cfDNA) became commercially available in Australia in 2012.…”

“…Concerns have frequently been expressed that access to screening, and to information about screening, has not been equal for all pregnant women in Australia …”

Down syndrome screening in the 21st century – More inequitable than ever

“…Now in 2017 in this issue of ANZJOG we have Rebecca Moses et al ., from a large multicultural pregnancy service in Western Sydney, describing the results of a retrospective cohort study of women attending for antenatal care who received a diagnosis of DS, comparing women who had a diagnosis made antenatally with those whose diagnosis was made in the neonate . Over the period 2006–2015, 59% of 129 cases of DS had an antenatal diagnosis and 41% a diagnosis following birth.…”