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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.069377v1 96/12/2139    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Khoshnood, B. Articles by Blondel, B. Search for Related Content PubMed PubMed Citation Articles by Khoshnood, B. Articles by Blondel, B.

Babak Khoshnood, MD, PhD, Catherine De Vigan, MD, Véronique Vodovar, RN, Gérard Bréart, MD, François Goffinet, MD, PhD and Béatrice Blondel, PhD

The authors are with the Epidemiological Research Unit on Perinatal and Women’s Health, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France.

Correspondence: Requests for reprints should be sent to Babak Khosh-nood, MD, PhD, INSERM U149, 16 Ave Paul Vaillant Couturier, 94807 Villejuif Cedex, France (e-mail: khoshnood{at}vjf.inserm.fr).

Objectives. We assessed socioeconomic differences in probabilities of prena-tal 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.