Low uptake of prenatal screening for Down syndrome in minority ethnic groups and socially deprived groups: a reflection of women's attitudes or a failure to facilitate informed choices?
Low uptake of prenatal screening for Down syndrome in minority ethnic groups and socially deprived groups: a reflection of women's attitudes or a failure to facilitate informed choices?
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DOI：
10.1093/ije/dyi021
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发表时间：
2005-04-01
影响因子：
7.7
通讯作者：
Marteau, TM
中科院分区：
文献类型：
--
作者：
Dormandy, E;Michie, S;Marteau, TM
背景目前尚不清楚少数民族妇女和社会经济弱势妇女产前筛查黎明综合征的低摄取率是否反映了对接受测试的更消极的态度或妇女不符合他们的态度，即不做出知情的选择。结果白色和社会经济地位较高的妇女比其他妇女的吸收率高。对接受测试的态度没有差异;所有妇女都表示了相对积极的态度。白色和社会经济地位较低的女性的接受态度一致性高于其他女性，特别是那些对接受测试持积极态度的女性（76%的白色女性持积极态度，而南亚女性为45%[差异31%，95%置信区间（95% CI）18-43]和78%的社会经济地位较低的妇女与63%的处境较不利的妇女相比（差异15%，95% CI 7-24））。控制人口统计学变量，南亚和社会经济弱势妇女的积极态度不太可能比其他妇女作出知情选择[比值比（OR）0.22，95%CI 0.10-0.45和OR 0.62，95%CI 0.41-0.93，分别为]结论：少数民族妇女和社会经济弱势妇女对唐氏综合征筛查的接受率较低，并不反映出对唐氏综合征的负面态度。筛查，而不是在这项研究中评估的知情选择率较低。医疗保健系统似乎有利于知情选择的背景下，产前筛查唐氏综合征筛查不太好的妇女从少数民族群体和那些谁是社会经济上处于不利地位的比其他妇女。
Background It is not known if lower uptake of prenatal screening for Dawn syndrome in women from minority ethnic groups and socioeconomically disadvantaged women reflects more negative attitudes towards undergoing the test or women not acting in line with their attitudes i.e. not making an informed choice.Methods Uptake of prenatal screening, attitudes towards undergoing the test, uptake-attitude consistency, and informed choice were assessed in a prospective study of 1499 pregnant women attending two UK hospitals.Results Uptake was higher in white and socioeconomically advantaged women than in other women. There were no differences in attitudes towards undergoing the test; all women expressed relatively positive attitudes. Uptake-attitude consistency was higher in white and socioeconomically advantaged women than others, particularly in those with positive attitudes towards undergoing the test (76% white women with positive attitudes had the test compared with 45% South Asian women [difference 31%, 95% confidence interval (95% CI) 18-43] and 78% socioeconomically advantaged women compared with 63% more disadvantaged women (difference 15%, 95% Cl 7-24)). Controlling for demographic variables, South Asian and socioeconomically disadvantaged women with positive attitudes were less likely to make an informed choice than other women [odds ratio (OR) 0.22, 95% CI 0.10-0.45 and OR 0.62, 95% CI 0.41-0.93, respectively].Conclusion Lower uptake of screening for Down syndrome in women from minority ethnic groups and socioeconomically disadvantaged women does not reflect more negative attitudes towards screening but rather lower rates of informed choice, as assessed in this study. Healthcare systems appear to facilitate informed choices in the context of prenatal screening for Down syndrome screening less well for women from minority ethnic groups and those who are socioeconomically disadvantaged than for other women.