Factors Influencing Referrals for Prenatal Cytogenetic Diagnosis

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Abstract
The results of an investigation into factors influencing the referral of women for prenatal cytogenetic diagnosis, following mid-2nd-trimester amniocentesis are reported. The overall diagnostic amniocentesis rate for wonen over the age of 35 yr was 16.8%. Consecutive Brisbane [Australia] women (104) referred to the 2 laboratories offering chromosome analysis of amniotic fluid cells were included in this study. Women (72%) were referred for advanced maternal age. The socioeconomic status (SES) of the 140 women was skewed very significantly towards the professional and semiprofessional classes (Classes A and B on the Congalton Australian Four-point Scale). Of all women 27% are in SES Class D in the Brisbane population, but only 7.4% of such women (SES Class D) were within the group studied. Women 49% indicated that they themselves raised the question of prenatal diagnosis with their doctor. Diagnostic amniocentesis is not acceptable to a certain proportion of couples, but it is estimated that 60% would accept it if there were medical indications and if it were offered. Of those women who are at increased risk of having a child with a significant chromosomal abnormality (including those over the age of 35 yr) and to whom prenatal diagnosis is acceptable, 28% are actually receiving it in current practice. Those who do are a well informed, self-motivated upper and middle class group.