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Advances in medical technology and creation of disparities: the case of Down syndrome.

Abstract : OBJECTIVES: We assessed socioeconomic differences in probabilities of prenatal diagnoses of Down syndrome and continuation of pregnancies after such diagnoses, along with the effects of these differences on disparities in live-birth prevalences of Down syndrome. METHODS: Using population-based data derived from 1433 cases of Down syndrome and 3731 control births, we assessed age-adjusted effects of maternal occupation and geographic origin on prenatal diagnoses, as well as overall and live-birth odds, of Down syndrome. RESULTS: Maternal occupation and geographic origin had significant effects on the probability of a prenatal diagnosis of Down syndrome and on continuation of pregnancy after such a diagnosis. Women in lower-status occupational categories had higher odds of delivering a live-born infant with Down syndrome. In comparison with women in the highest-status occupational category, the age-adjusted odds ratio for a Down syndrome live birth among women without an occupation was 2.4 (95% confidence interval [CI] = 1.7, 3.3). By contrast, there were no disparities in age-adjusted overall likelihood of Down syndrome. CONCLUSIONS: Socioeconomic differences in use of prenatal testing have created disparities in the live-birth prevalence of Down syndrome. Overall Down syndrome risk does not vary according to socioeconomic status.
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Submitted on : Monday, April 11, 2011 - 9:18:41 AM
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Babak Khoshnood, Catherine de Vigan, Véronique Vodovar, Gérard Bréart, François Goffinet, et al.. Advances in medical technology and creation of disparities: the case of Down syndrome.. American Journal of Public Health, American Public Health Association, 2006, 96 (12), pp.2139-44. ⟨10.2105/AJPH.2005.069377⟩. ⟨inserm-00119020⟩



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