Influencing factors and utilization status of prenatal screening for Down's syndrome

Objective To describe the pregnant women's utilization of prenatal screening for Down's syndrome and its influencing factors.Methods From October 2007 to December 2008,4250 lyingin women in 54 hospitals were survcyed by stratified cluster sampling method in Zhejiang,IIunan and Sichuan,which located in Eastern,Central and Western China,respectively.Demographic characteristics,knowledge and health behaviors were collected by the questionnaire of lying-in women's utilization and influencing factors of prenatal screening for Down's syndrome.Whether to use prenatal screening was determined by the lying-in women' s medical history.Chi-square test and logistic regression analysis were used to analyze datas.Results Respondents' age was ( 26.92 ± 4.60) years old.The total utilization rate of prenatal screening for Down's syndrome was 40.0％ (1696/4237),and screening utilization rates in Zhejiang,Hunan and Sichuan were 48.23％ (682/1414),41.73％ (616/1476) and 29.55％ (398/1347),respectively.Screening utilization rates of respondents with college degree or above and high school or below were 72.68％ (697/959) and 30.46％ (998/3276),respectively.Screening utilization rates of urban and rural respondents were 63.00％ ( 952/1511 ) and 27.l1％ ( 732/2700 ),respectively.Screening utilization rates of respondents under 35 years old and over 35 years old were 41.40％ (1645/3973) and 19.32％(51/264).All differences were significant( all P values ＜ 0.05 ). A total of 79.14％ ( 1419/1793 ) of respondents thought it was necessary to take prenatal screening tor Down' s syndrome, and 79.47％( 1506/1895 )of respondents received doctors' suggestions,24.2％ (654/2702) of respondents who heard of prenatal screening for Down's syndrome could figure out the main pathogenic factors,while 23.0％(621/2702) didn't know any factors; 77.8％ (2102/2702) of respondents heard of prenatal screening for Down's syndrome,but 12.3％ (259/2102) didn't know the appropriate gestational weeks to uptake the screening,47.0％ (988/2102) knew of prenatal screening for Down' s syndrome through healthcare providers.Logistic regression analysis result demonstrated that living in Zhejiang (OR =1.62,95％ CI:1.26 2.08 ),city residence ( OR =2.06,95％ CI:1.63 - 2.60 ),with positive attitude to screening( OR =5.00,95％ CI:3.97 -6.29 ),pregnant women's age below 35 years old( OR =3.86,95％ CI:2.53 - 5.89),receiving advices from healthcare providers( OR =12.64,95.0％ CI:9.97 - 16.02),college degree or above educational level ( OR =2.67,95％ CI:2.03 - 3.50 ) were facilitating factors on utilization of prenatal screening for Down' s syndrome.Conclusion Pregnant women' s use of prenatal screening for Down' s syndrome was not enough,and living in Zhejiang,higher education level,rural respondents with age under 35years old, receiving advice from healtheare providers or not and their attitude toward necessity were significant promotive factors of utilization of prenatal screening for Down's syndrome. Key words: Down' s syndrome; Genetic screening; Prenatal screening; Factor analysis,statistical