Gene Expression

Down syndrome and abortion rates

The 90% rate of abortion upon prenatal discovery that a fetus likely has Down Syndrome is being quoted a lot today. Is it true? Seems like it. Termination rates after prenatal diagnosis of Down syndrome, spina bifida, anencephaly, and Turner and Klinefelter syndromes: a systematic literature review:

…Termination rates varied across conditions. They were highest following a prenatal diagnosis of Down syndrome (92 per cent; CI: 91 per cent to 93 per cent) and lowest following diagnosis of Klinefelter syndrome (58 per cent; CI: 50 per cent to 66 per cent). Where comparisons could be made, termination rates were similar in the 1990s to those reported in the 1980s.

Seems the same in China, Attitudes towards termination of pregnancy among Hong Kong Chinese women attending prenatal diagnosis counselling clinic:

Approximately 90% would choose TOP for lethal chromosomal abnormalities and Down syndrome while about 50% would do so for Klinefelter or Turner syndromes. Over 80% were of the opinion that women should be given the right to choose TOP for lethal congenital malformation as well as for Down syndrome after 24 weeks of gestation. This figure dropped to 55.7% for non-lethal structural malformation that requires postnatal treatment. Religious background was a significant factor for a negative attitude towards TOP.

But it’s good to check your intuitions, Attitudes towards termination for fetal abnormality: comparisons in three European countries:

…. In all, more than 1,700 study participants completed questionnaires. Overall, health professionals were more likely than the lay persons to report that they would opt for termination following diagnosis of a fetal abnormality. Differences were found between countries and study groups. German respondents were least likely to report that they would undergo termination in the case of a fetal abnormality while Portuguese respondents were most likely to report that they would undergo a termination….

Finally, that doesn’t mean that Down Syndrome is going to be a condition of the past, Impact of prenatal diagnosis on the prevalence of live births with Down syndrome in the eastern half of Switzerland 1980-1996:

Despite increasing prenatal detection rates of trisomy 21 foetuses (an increase of 169% in the last 5 versus the first 5 years of the study period) and subsequent termination of pregnancies, the number of liveborn Down syndrome children remained constant. The reason is a shift towards a higher mean maternal age from 28 to 30 years between 1980 and 1996. If mean maternal age at delivery was considered, the observed increase of trisomy 21 conceptions matched well with the calculated figures.

Comments

  1. #1 Jason Malloy
    September 8, 2008
  2. #2 Stacy
    September 8, 2008

    This kind of surprises me that 90% of people who find out that they will have a Down Syndrome will terminate the baby. I mean, Down Syndrome is definitely unfortunate to live with and would be tough for everyone involved, but it is not a disease like a death sentence. I’m sure that any Down Syndrome kid is just like any normal kid inside. They still are humans, they have feelings, and I don’t think that they deserve to be aborted.

  3. #3 R E G
    September 9, 2008

    I’m just baffled at the 50 % rate for Turner’s syndrome. My sister had it, and lived a very meaningful life. She was the short sister, who never mastered the multiplication tables, but got a university degree and worked in social services until she died. She was gravely offended at any implication that she was disabled in any way.

  4. #4 Paul
    September 9, 2008

    The report on attitudes to termination for fetal abnormality in three European countries was interesting. The article seems to focus on the value systems of the people questioned, and given the past experiences with eugenics in Germany during the Nazi era such values might play an important role, but I wonder if their importance are over stated.

    Social care provision in Germany is in general far better than in the United Kingdom, and I would be surprised if this more generous state assistance doesn’t extend to help for the parents of a disabled child. Likewise Portugal is the poorest (by some way) of the three countries studies, so I would not be surprised if Portugal was less generous in the help it provides to the parents of disabled children. The availability or not of such assistance, or the perception of its availability, would be expected to be an important consideration when deciding whether or not to continue with the pregnancy.

  5. #5 Inductivist
    September 9, 2008

    Uncork Corky? Then who’d say hi to me while bagging my groceries? And having him as a son–either he’d always be around to talk to his old man, or if he lived on his own (like George Will’s does) I wouldn’t get mad when he never calls.

  6. #6 Dave
    September 14, 2008

    But it’s good to check your intuitions, Attitudes towards termination for fetal abnormality: comparisons in three European countries:

    But it is good to check your understanding of the different between actual abortion rates and “reported” attitudes.

    All we know for sure from your cite about Germany, Portugal and the UK is the degree to which people will fib on a questionnaire!

    The article seems to focus on the value systems of the people questioned and given the past experiences with eugenics in Germany during the Nazi era such values might play an important role, but I wonder if their importance are over stated.

    The results compared to actual behavior tell us about one thing: truthfulness

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