Comparison of the use of amniocentesis in two countries with different policies for prenatal testing: the case of France and the United States

Abstract

Objective: To compare maternal age- and education-specific use of amniocentesis in France and the United States.

Methods: We used two nationally representative datasets, National Perinatal Survey of 1998 in France (n = 12 816) and National Center for Health Statistics birth data for 1997 in the United States (n = 3 799 975). Analyses included binomial regression with test of interactions between country, maternal age and education.

Results: Amniocentesis use was more than threefold greater in France than in the United States (Risk Ratio (RR) 3.2, 95% CI, 3.1-3.4). This was true across maternal age and education groups. Differences in use of amniocentesis were greatest, however, for women with lower levels of education and older (>/=38 years) women.

Conclusion: Our results suggest greater use and lesser disparities in maternal age- and education-specific use of amniocentesis in France as compared to that in the United States. These differences may be due to several factors, including differences in women's cultural values and preferences. They may also represent barriers to effective access to prenatal testing, particularly for women in lower socioeconomic groups, in the United States.