{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:47:23Z","timestamp":1765370843748,"version":"3.46.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J of Med Genetics Pt A"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    In this study, we sought to analyze the associations of global macroeconomic policy decisions on live births with Down syndrome (DS). As countries made prenatal screening more available and financially covered by their governments, we modeled the impact on the \u201creduction percentage\u201d for DS\u2014that is, the percentage of fetuses with DS that were not born as a consequence of selective terminations. The log\u2010odds of the reduction in live births of children with DS (due to selective abortion) were estimated using maternal age\u2010based prevalence models and actual birth data. These log\u2010odds were then predicted using independent variables, including the availability and reimbursement of prenatal screening, maternal age, Gross National Income per capita, and country\u2010specific effects. Data were analyzed using least squares regression with robust standard errors and model validation. When there is a full change from \u201cno availability of screening\u201d to \u201cserum screening available and reimbursed,\u201d we observed a large effect on the reduction percentage (OR\u2009=\u20093.24,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0001). If a country, whose baseline reduction percentage was 5%, 25%, or 50%, were to make this policy switch, then the reduction would be expected to increase to about 15%, 52%, and 76%, respectively, when all other variables are held constant. Increases in maternal age and Gross National Income also were associated with increased reduction percentages. If a country were to expand the availability or reimbursement of prenatal screening for DS, while all other factors are constant, that country should also expect to have fewer live births with DS as a consequence.\n                  <\/jats:p>","DOI":"10.1002\/ajmg.a.64228","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T07:31:32Z","timestamp":1755761492000},"page":"84-92","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Countrywide Variables Associated With the Reduction of Fetuses With Down Syndrome"],"prefix":"10.1002","volume":"200","author":[{"given":"Petrus H. F. M.","family":"van Casteren","sequence":"first","affiliation":[{"name":"Amsterdam School of Economics University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4990-5711","authenticated-orcid":false,"given":"Gert","family":"de Graaf","sequence":"additional","affiliation":[{"name":"Dutch Down Syndrome Foundation  Meppel the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Buckley","sequence":"additional","affiliation":[{"name":"Down Syndrome Education International, Kirkby Lonsdale  Cumbria UK"},{"name":"Down Syndrome Education USA  Irvine California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5232-9882","authenticated-orcid":false,"given":"Brian G.","family":"Skotko","sequence":"additional","affiliation":[{"name":"Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Pediatrics Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012599"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469\u20100705.2001.00457.x"},{"key":"e_1_2_10_4_1","unstructured":"deGraaf G. F.Buckley andB.Skotko.2024.\u201cPeople Living with Down Syndrome in the USA: Births and Population.\u201dhttps:\/\/go.downsyndromepopulation.org\/usa\u2010factsheet."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.37001"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2016.127"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41431\u2010020\u201000748\u2010y"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gim.2025.101422"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gim.2022.08.029"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2055102920987455"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2013.12.009"},{"key":"e_1_2_10_12_1","unstructured":"Eurostat.2022.\u201cLive Births by Mother's Age and Birth Order.\u201dhttps:\/\/ec.europa.eu\/eurostat\/databrowser\/view\/DEMO_FORDAGEC\/default\/table?lang=en."},{"volume-title":"Joint EVS\/WVS 2017\u20132022 Dataset (Joint EVS\/WVS)","year":"2024","author":"GESIS","key":"e_1_2_10_13_1"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102393\u201014\u2010264"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20140110"},{"key":"e_1_2_10_16_1","unstructured":"International Labour Organization.2024.\u201cData and Statistics.\u201dApril 16.https:\/\/www.ilo.org\/data\u2010and\u2010statistics."},{"key":"e_1_2_10_17_1","unstructured":"Mitchell T.2018.\u201c3. How Religious Commitment Varies by Country Among People of All Ages.\u201dPew Research Center. June 13.https:\/\/www.pewresearch.org\/religion\/2018\/06\/13\/how\u2010religious\u2010commitment\u2010varies\u2010by\u2010country\u2010among\u2010people\u2010of\u2010all\u2010ages\/."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/jms.9.1.2"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejhg.5200655"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrg1525"},{"key":"e_1_2_10_21_1","unstructured":"UNdata.2025.\u201cUNdata| Record View | Live Births by Birth Order and Age of Mother.\u201dAccessed April 28 2025.https:\/\/data.un.org\/Data.aspx?q=Live+births+by+birth+order+and+age+of+mother&d=POP&f=tableCode%3a58."},{"key":"e_1_2_10_22_1","unstructured":"United Nations Development Programme.2023.\u201cData Center Human Development Reports.\u201dAccessed January 6 2023.https:\/\/hdr.undp.org\/data\u2010center\/documentation\u2010and\u2010downloads."},{"volume-title":"World Population Prospects 2022, Online Edition","year":"2022","author":"United Nations, Department of Economic and Social Affairs, Population Division","key":"e_1_2_10_23_1"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S31183"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1890\/10\u20100340.1"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41431\u2010023\u201001330\u2010y"},{"key":"e_1_2_10_27_1","unstructured":"World Bank Group.2025.\u201cWorld Bank Open Data.\u201dAccessed April 28 2025.https:\/\/data.worldbank.org."},{"key":"e_1_2_10_28_1","unstructured":"World Values Survey.2023.\u201cWVS Database.\u201dAccessed January 27 2023.https:\/\/www.worldvaluessurvey.org\/WVSOnline.jsp."}],"container-title":["American Journal of Medical Genetics Part A"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajmg.a.64228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:07:40Z","timestamp":1765357660000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajmg.a.64228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,21]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/ajmg.a.64228"],"URL":"https:\/\/doi.org\/10.1002\/ajmg.a.64228","archive":["Portico"],"relation":{},"ISSN":["1552-4825","1552-4833"],"issn-type":[{"type":"print","value":"1552-4825"},{"type":"electronic","value":"1552-4833"}],"subject":[],"published":{"date-parts":[[2025,8,21]]},"assertion":[{"value":"2025-06-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}