Effects of maternal age and education on the pattern of prenatal testing: implications for the use of antenatal screening as a solution to the growing number of amniocenteses.

Abstract

This study was undertaken to assess age-specific effects of maternal education on patterns of prenatal testing. We used data from a sample of all births in France in 1998. Statistical analysis included logistic regression and likelihood ratio tests. The rate of amniocentesis of women without serum screening was 7.3% for those with 12 years or less, and 16.7% for those with more than 12 years of education. Women with lower levels of education were about 50% more likely to have an amniocentesis if they had serum screening (odds ratio [OR], 1.5; 95% CI, 1.2-1.8). In contrast, women with higher levels of education were less likely to have an amniocentesis with screening (OR, 0.7; 95% CI, 0.6-0.8); the education effect persisted across maternal age groups. Many women eligible for reimbursed serum screening, in particular those with higher levels of education, obtain amniocentesis without serum screening. This might limit the use of antenatal screening as a solution to the growing number of amniocenteses.