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Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for Neural Tube Defects and Down’s syndrome

Biomedical Sciences Research Institute Computer Science Research Institute Environmental Sciences Research Institute Nanotechnology & Advanced Materials Research Institute

Boyd, Patricia A, DeVigan, Catherine, Khoshnood, Babak, Loane, Maria, Garne, Ester, Dolk, Helen and EUROCAT, Working Group (2008) Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for Neural Tube Defects and Down’s syndrome. British Journal Obstetrics & Gynaecology , 115 (6). pp. 689-696. [Journal article]

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URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2344123/pdf/bjo0115-0689.pdf/?tool=pmcentrez

DOI: 10.1111/j.1471-0528.2008.01700.x

Abstract

Objective To 'map' the current (2004) state of prenatal screening in Europe.Design (i) Survey of country policies and (ii) analysis of data from EUROCAT (European Surveillance of Congenital Anomalies) population-based congenital anomaly registers.Setting Europe.Population Survey of prenatal screening policies in 18 countries and 1.13 million births in 12 countries in 2002–04.Methods (i) Questionnaire on national screening policies and termination of pregnancy for fetal anomaly (TOPFA) laws in 2004. (ii) Analysis of data on prenatal detection and termination for Down's syndrome and neural tube defects (NTDs) using the EUROCAT database.Main outcome measures Existence of national prenatal screening policies, legal gestation limit for TOPFA, prenatal detection and termination rates for Down's syndrome and NTD.Results Ten of the 18 countries had a national country-wide policy for Down's syndrome screening and 14/18 for structural anomaly scanning. Sixty-eight percent of Down's syndrome cases (range 0–95%) were detected prenatally, of which 88% resulted in termination of pregnancy. Eighty-eight percent (range 25–94%) of cases of NTD were prenatally detected, of which 88% resulted in termination. Countries with a first-trimester screening policy had the highest proportion of prenatally diagnosed Down's syndrome cases. Countries with no official national Down's syndrome screening or structural anomaly scan policy had the lowest proportion of prenatally diagnosed Down's syndrome and NTD cases. Six of the 18 countries had a legal gestational age limit for TOPFA, and in two countries, termination of pregnancy was illegal at any gestation.Conclusions There are large differences in screening policies between countries in Europe. These, as well as organisational and cultural factors, are associated with wide country variation in prenatal detection rates for Down's syndrome and NTD.

Item Type:Journal article
Faculties and Schools:Faculty of Life and Health Sciences
Faculty of Life and Health Sciences > School of Nursing
Research Institutes and Groups:Institute of Nursing and Health Research
Institute of Nursing and Health Research > Maternal, Fetal and Infant Research
ID Code:23648
Deposited By:Ms Maria Loane
Deposited On:23 Nov 2012 12:02
Last Modified:23 Nov 2012 12:02

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