Sociodemographic Differences in Prenatal Diagnosis of Chromosomal Anomalies: A Population-Based Study

Background: In Europe, about 76% of cases of chromosomal anomalies are prenatally diagnosed. Prenatal diagnosis allows more efficient planning of postnatal treatment and helps parents for an informed decision about the continuation of pregnancy. The main aim of this study was to evaluate whether the sociodemographic maternal characteristics affect the probability of prenatal diagnosis of chromosomal anomalies.Methods: Cases of chromosomal anomalies in the period 2005–2017 came from the population-based registry of congenital anomalies of Tuscany (Italy). Differences in the proportion of cases prenatally diagnosed were investigated through the following maternal characteristics: education, geographic origin and occupation. The association between cases of termination of pregnancy after prenatal diagnosis and maternal characteristics was also analysed. Odds Ratios (OR) adjusted by maternal age were calculated using logistic regression models. Results were provided for all cases of chromosomal anomalies and for Down syndrome cases.Results: A total of 1,419 cases were included in the study. Cases prenatally diagnosed were 1,186 (83.6%). We observed a higher proportion of cases not prenatally diagnosed among cases with low maternal education compared to those with high maternal education (OR = 2.16, p < 0.001) and in women from high migratory outflow countries, compared to the Italian ones (OR = 2.85, p < 0.001). For prenatally diagnosed Down syndrome cases, we observed a higher proportion of termination of pregnancy for women with low education level (OR = 4.36, p = 0.023).Conclusions: In our study evidence of differences in the probability of prenatal diagnosis of chromosomal anomalies associated with maternal education and geographic origin was found. Population-based studies investigating sociodemographic disparities can provide essential information for targeted public health programs. Further studies are recommended to monitor the impact of the increasing availability of non-invasive screening tests.

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Using population-based data to predict the impact of introducing noninvasive prenatal diagnosis for Down syndrome

Genetics in Medicine ◽

10.1097/gim.0b013e3181d5d022 ◽

2010 ◽

Vol 12 (5) ◽

pp. 298-303 ◽

Cited By ~ 23

Author(s):

Marleen R Susman ◽

David J Amor ◽

Evelyne Muggli ◽

Alice M Jaques ◽

Jane Halliday

Keyword(s):

Down Syndrome ◽

Prenatal Diagnosis ◽

Population Based ◽

Noninvasive Prenatal Diagnosis ◽

The Impact

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The impact of legal termination of pregnancy and of prenatal diagnosis on the birth prevalence of Down syndrome in Denmark

Annals of Human Genetics ◽

10.1111/j.1469-1809.1983.tb00979.x ◽

1983 ◽

Vol 47 (2) ◽

pp. 123-131 ◽

Cited By ~ 29

Author(s):

M. MIKKELSEN ◽

G. FISCHER ◽

J. HANSEN ◽

B. PILGAARD ◽

J. NIELSEN

Keyword(s):

Down Syndrome ◽

Prenatal Diagnosis ◽

Termination Of Pregnancy ◽

Birth Prevalence ◽

The Impact

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Identifying Prenatal Opioid Exposure in Health Administrative Data for Public Health Surveillance and Epidemiologic Research

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1453 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Andi Camden ◽

Teresa To ◽

Joel G Ray ◽

Tara Gomes ◽

Li Bai ◽

...

Keyword(s):

Prescription Drug ◽

Administrative Data ◽

Population Based ◽

Emergency Department Visits ◽

Prescription Data ◽

Opioid Use ◽

Health Administrative Data ◽

Maternal Characteristics ◽

Data Source ◽

The Impact

IntroductionAccurate estimation of prenatal opioid exposure (POE) is needed for population-based surveillance & research but can be challenging with health administrative data due to varying definitions & methods. Prior research has relied primarily on infant records with a diagnosis of neonatal abstinence syndrome (NAS). Objectives and Approach1) Evaluate the impact of using different definitions of maternal opioid use in the estimation of POE; 2) Investigate whether maternal characteristics vary by the type of definition used. Population-based cross-sectional study of all hospital births (N= 454,746) from 2014-2017 in Ontario, Canada. Multiple linked population-based health administrative databases were used to identify opioid-related pre- & perinatal Emergency Department visits & hospitalizations & opioid prescriptions. We examined how pre-conception & in-pregnancy maternal characteristics varied by using different approaches to ascertain POE. ResultsThere were 9624 live/still births with POE. Ascertainment of POE was highest using maternal prescription drug data (79%) & infant hospital records with NAS (45%). Maternal characteristics varied by data source used for POE ascertainment. Opioid-related health care during pregnancy identified a high-risk phenotype, contrasted with those ascertained through prescription data, with respective rates of 64% vs. 54% for social assistance, 37% vs. 12% for polydrug use, 23% vs. 6% for alcohol use, 26% vs. 19% for 3+ live births, 13% vs. 5% for victim of violence, 12% vs. 6% for involvement in criminal justice system & 64% vs. 17% for mental health & addictions hospital care. Conclusion / ImplicationsPOE ascertainment differs by health administrative data source & ability to link both across maternal records and with infant. Prescription drug data identified the highest number of opioid-exposed births and, with linked healthcare records, is useful to identify illicit opioid use & additional risk factors. Clinically meaningful differences in maternal characteristics of opioid users exist by POE ascertainment method.

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Termination of pregnancy following a prenatal diagnosis of Down syndrome: A qualitative study of the decision-making process of pregnant couples

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/aogs.13386 ◽

2018 ◽

Vol 97 (10) ◽

pp. 1228-1236 ◽

Cited By ~ 8

Author(s):

Stina Lou ◽

Kathrine Carstensen ◽

Olav Bjørn Petersen ◽

Camilla Palmhøj Nielsen ◽

Lone Hvidman ◽

...

Keyword(s):

Decision Making ◽

Down Syndrome ◽

Prenatal Diagnosis ◽

Qualitative Study ◽

Termination Of Pregnancy ◽

Decision Making Process

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Indirect impact of the COVID-19 pandemic on emergency department presentations and hospital admissions for urgent early pregnancy conditions: a population-based retrospective cohort study

10.22541/au.164009415.56581064/v1 ◽

2021 ◽

Author(s):

Lisa Hui ◽

Wanyu Chu ◽

Elizabeth McCarthy ◽

Mary McCarthy ◽

Paddy Moore ◽

...

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Early Pregnancy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Linear Prediction ◽

Hospital Admissions ◽

Population Based ◽

Termination Of Pregnancy ◽

The Impact

Objective: To compare emergency department (ED) presentations and hospital admissions for urgent early pregnancy conditions in Victoria before and after the onset of COVID-19 lockdown on 31 March 2020. Design: Population-based retrospective cohort study Setting: Australian state of Victoria Population: Pregnant women presenting to emergency departments or admitted to hospital Methods: We obtained state-wide hospital separation data from the Victorian Emergency Minimum Dataset and the Victorian Admitted Episodes Dataset from January 1, 2018, to October 31, 2020. A linear prediction model based on the pre-COVID period was used to identify the impact of COVID restrictions. Main outcome measures: Monthly ED presentations for miscarriage and ectopic pregnancy, hospital admissions for termination of pregnancy, with subgroup analysis by region, socioeconomic status, disease acuity, hospital type. Results: There was an overall decline in monthly ED presentations and hospital admissions for early pregnancy conditions in metropolitan areas where lockdown restrictions were most stringent. Monthly ED presentations for miscarriage during the COVID period were consistently below predicted, with the nadir in April 2020 (790 observed vs 985 predicted, 95% CI 835-1135). Monthly admissions for termination of pregnancy were also below predicted throughout lockdown, with the nadir in August 2020 (893 observed vs 1116 predicted, 95% CI 905-1326). There was no increase in ED presentations for complications following abortion, ectopic or molar pregnancy during the COVID period. Conclusions: Fewer women in metropolitan Victoria utilized hospital-based care for early pregnancy conditions during the first seven months of the pandemic, without any observable increase in maternal morbidity.

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The Surplus Effect in Adaptive Behaviour in Down Syndrome: What Can Promote It?

Brain Sciences ◽

10.3390/brainsci11091188 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1188

Author(s):

Anastasia Dressler ◽

Valetina Perelli ◽

Margherita Bozza ◽

Stefania Bargagna ◽

Franz Benninger ◽

...

Keyword(s):

Down Syndrome ◽

Cognitive Skills ◽

Parental Education ◽

Maternal Education ◽

Demographic Data ◽

Adaptive Skills ◽

Adaptive Behaviour ◽

Vineland Adaptive Behaviour Scales ◽

Inclusive Schooling ◽

The Impact

Background: In Down syndrome (DS), adaptive behaviour often shows a “surplus effect” (i.e., higher adaptive abilities than expected from cognitive skills). As inclusive schooling has become mandatory in Italy, we studied the impact of school inclusion on the surplus effect of adaptive behaviour in adult DS, considering potential confounding factors such as parental education. Methods: All consecutive DS individuals from three different sites were queried prospectively regarding type of schooling (inclusive and non-inclusive). Demographic data were documented; cognitive abilities and adaptive behaviour were assessed (Coloured Progressive Matrices and Vineland Adaptive Behaviour Scales). The aim was to establish the presence of a surplus effect in adaptive behaviour, primarily in the overall level and secondarily in the main domains and subdomains. A multivariable-adjusted logistic regression model was used for the association of schooling, and parental education. Results: The majority (65%) showed a surplus effect in adaptive behaviour and had attended inclusive schools (85%). Higher adaptive skills as well as early and longer functional treatment programmes were more readily available for younger individuals. In the group of inclusive schooling, the surplus effect on overall adaptive behaviour was present in 70% as opposed to 38% in the group without inclusive schooling, significant when adjusted for gender and maternal education. This was also observed in socialisation, written, and community, and after adjustment in playing and leisure time. Conclusions: Adaptive behaviour showed a surplus effect in the majority of DS adults, even more so after inclusive schooling. Younger adults showed higher adaptive skills. Moreover, female gender and higher maternal educational level significantly enhanced this surplus effect.

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Maternal characteristics in childhood and smoking at age of 15: Findings from the Czech Republic

European Journal of Public Health ◽

10.1093/eurpub/ckz186.156 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

J Pikhartova ◽

L Andryskova ◽

H Pikhart

Keyword(s):

Maternal Employment ◽

Maternal Education ◽

Smoking Behaviour ◽

Young Adolescents ◽

Maternal Characteristics ◽

Parental Employment ◽

Repeated Attempt ◽

Behavioural Characteristics ◽

Employed Mothers ◽

The Impact

Abstract Objective Maternal employment has been shown to influence child’s health, cognitive and behavioural outcomes. There is only a limited number of studies in Central Europe investigating the impact of parental employment on the uptake of smoking in children. The aim of this work is to look at the influence of maternal employment over the whole period of childhood of their children, and other maternal social and behavioural characteristics on the uptake of smoking among children aged 15 in the Czech part of European Longitudinal Study of Pregnancy and Childhood (ELSPAC). Methods There were 971 individuals with complete data on smoking behaviour at age of 15, pattern of maternal employment between child ages 3 and 15, and other covariates including gender, maternal age, maternal education and marital status, household income, and maternal smoking. Logistic regression was used to analyse the association between maternal employment and smoking in their children. Results 37% of adolescents aged 15 years reported trying cigarette more than once. Preliminary results suggest that those whose mothers were in paid work were more likely to be smoking at age 15. When stratified by maternal education, the association between maternal employment and smoking was particularly strong among university educated mothers. Those whose mothers were never employed were 4-times more likely to smoke than those whose mothers were continuously employed between ages 3 and 15. The association between maternal employment and smoking was weaker in other strata of maternal education. Conclusions Although maternal employment might have only a limited role in development of smoking behaviour of young adolescents, the association between maternal employment during childhood and young adolescents’ smoking does exist and is particularly strong among those with university educated mothers. Key messages More than one third of Czech adolescents self-reported repeated attempt to smoke cigarettes or cigars or pipe at the beginning of new Millennium. Data suggest that adolescents whose mothers had not been employed were more likely to smoke than those of employed mothers.

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Termination of pregnancy following a Down Syndrome diagnosis: decision-making process and influential factors in a Muslim but secular country, Turkey

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0147 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Duygu Adiyaman ◽

Bahar Konuralp Atakul ◽

Melda Kuyucu ◽

Alkim Gulsah Sahingoz Yildirim ◽

Halil Gursoy Pala

Keyword(s):

Decision Making ◽

Down Syndrome ◽

Chromosome Analysis ◽

Tertiary Hospital ◽

Influential Factors ◽

Termination Of Pregnancy ◽

Decision Making Process ◽

Muslim Country ◽

Hospital Data ◽

Maternal Characteristics

AbstractShort CommunicationsThis study aims to present the termination of pregnancy (TOP) rates and elucidate the decision-making process following a prenatal diagnosis of Trisomy 21 in Turkey.Objectives and MethodsThis retrospective single-center study was conducted with 146 pregnant women between January 2016 and December 2019 in a tertiary hospital. Data on maternal characteristics, sonographic findings, indications for chromosome analysis, and educational, religious, and economic factors that can influence the parental decision process were collected.ResultsThe TOP rate of Down syndrome (DS) in our center was 78.8%. We concluded that maternal age, earlier diagnosis, indication for chromosome analysis, and previous pregnancies had no effect on the TOP decision. On the other hand, not having a minor or a major sonographic sign, employed mothers, middle- and high-income families, and families having a secondary or higher education tended to terminate the pregnancy affected by DS at statistically higher rates.ConclusionsThere are many studies worldwide investigating the TOP preferences for DS. However, there is limited data about TOP rates and influential factors affecting the decision-making process in Muslim countries. This study contributes by clarifying the factors in the decision-making process and elucidating perspectives about TOP in a Muslim country with a unique status: Turkey.

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Associations between infant and maternal characteristics measured at child age 5 months and maternal feeding styles and practices up to child age two years

PLoS ONE ◽

10.1371/journal.pone.0261222 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0261222

Author(s):

Christine Helle ◽

Elisabet R. Hillesund ◽

Nina C. Øverby

Keyword(s):

Maternal Education ◽

Longitudinal Design ◽

Controlled Trial ◽

Feeding Practices ◽

Overweight And Obesity ◽

Maternal Characteristics ◽

Feeding Styles ◽

Maternal Feeding Practices ◽

The Impact ◽

Child Age

Facilitating positive feeding practices from infancy may be an important strategy to prevent childhood overweight and obesity. Since the feeding situation early in life constitutes a bidirectional relationship, it is important to understand the impact of both maternal and infant characteristics on maternal feeding practices to intervene in a customized and tailored way. Few studies have concurrently examined associations between maternal and infant characteristics in relation to early maternal feeding practices. The aim of the present study was to explore potential associations between infant and maternal characteristics measured at child age five months, and maternal feeding styles and practices during the child’s first two years. Cross-sectional data from a Norwegian randomized controlled trial in which participants responded to questionnaires at child age 5 months (n = 474), 12 months (n = 293) and 24 months (n = 185) were used to explore potential associations. All maternal and child predictor variables were collected at child age five months. Maternal feeding styles and practices were mapped using subscales from the Infant Feeding Questionnaire at child age 5 and 12 months and the Child Feeding Questionnaire and the Parental Feeding Style Questionnaire at child age 24 months. The subscale-scores were split into roughly equal tertiles, and the upper or lower tertile for the outcome of interest were used to create binary outcome variables. Multivariable binary logistic regression models were conducted for each outcome. We found that maternal education and mental health symptoms as well as infant weight, temperament and feeding mode were associated with maternal feeding styles and practices over time. Our findings indicate that risk factors which may have long-term implications for child weight and health outcomes can be identified early. Larger, population-based studies with a longitudinal design are needed to further explore these pathways.

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