{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:32:41Z","timestamp":1785850361552,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T00:00:00Z","timestamp":1516579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","award":["NNF16OC0018772"],"award-info":[{"award-number":["NNF16OC0018772"]}],"id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Denmark was the first country in the world to implement a national, free\u2010for\u2010all offer of prenatal screening for Down syndrome to all pregnant women. It has a high uptake (&gt;90%) compared to other countries. Thus, Denmark offers an interesting case for investigating the consequences of implementing comprehensive, national prenatal screening guidelines. The aim of this study was to describe the historical developments in invasive procedures, pre\u2010\/postnatal diagnoses of Down syndrome and Down syndrome live births in the period 1973\u20132016 in Denmark.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Data on invasive procedures, pre\u2010 and postnatal Down syndrome diagnoses were retrieved from the Danish Cytogenetic Central Registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1973 to 1993, screening based on maternal age and high\u2010risk indications resulted in a constant increase in invasive procedures. After the introduction of the triple test in 1994, invasive procedures decreased for the first time in 20\u00a0years. Following the introduction of an offer of combined screening to all pregnant women in 2004, the number of invasive procedures decreased markedly, while there was a concurrent increase in prenatal diagnoses of Down syndrome. Additionally, the number of Down syndrome live births decreased suddenly and significantly, but subsequently stabilized at 23\u201335 annual live births. Of these, the majority were diagnosed postnatally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Though prenatal screening technologies constantly improve, it was the introduction of and adherence to national guidelines that resulted in marked shifts in screening procedures and outcome in Denmark.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13273","type":"journal-article","created":{"date-parts":[[2017,12,1]],"date-time":"2017-12-01T19:59:44Z","timestamp":1512158384000},"page":"195-203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["National screening guidelines and developments in prenatal diagnoses and live births of Down syndrome in 1973\u20132016 in Denmark"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6177-5780","authenticated-orcid":false,"given":"Stina","family":"Lou","sequence":"first","affiliation":[{"name":"Center for Fetal Diagnostics Aarhus University Hospital Aarhus Denmark"},{"name":"DEFACTUM \u2013 Public Health &amp; Health Services Research Central Denmark Region Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olav B.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Center for Fetal Diagnostics Aarhus University Hospital Aarhus Denmark"},{"name":"Fetal Medicine Unit Department of Obstetrics and Gynecology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1592-5407","authenticated-orcid":false,"given":"Finn S.","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Department of Obstetrics and Gynecology Copenhagen University Hospital Hvidovre Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida C.B.","family":"Lund","sequence":"additional","affiliation":[{"name":"Center for Fetal Diagnostics Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Clinical Genetics Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Kj\u00e6rgaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Danish Cytogenetic Central Registry Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Vogel","sequence":"additional","affiliation":[{"name":"Center for Fetal Diagnostics Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Clinical Genetics Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,22]]},"reference":[{"issue":"3","key":"e_1_2_10_2_1","first-page":"CD003252","article-title":"Amniocentesis and chorionic villus sampling for prenatal diagnosis","author":"Alfirevic Z","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000271995"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1860"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38730.655197.AE"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13270"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12371"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.37001"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b3794"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0180348"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S45228"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a2547"},{"key":"e_1_2_10_13_1","volume-title":"Retningslinjer for pr\u00e6natal diagnostik","author":"Danish National Board of Health","year":"2004"},{"key":"e_1_2_10_14_1","unstructured":"Regionernes kliniske kvalitetsudviklingsprogram.Dansk F\u00f8talmedicinsk database. National \u00e5rsrapport 2014. [Danish fetal medicine database. Annual report]. (In Danish. No abstract available).Copenhagen:Regionernes kliniske kvalitetsudviklingsprogram 2014.http:\/\/www.dfms.dk\/images\/foetodatabase\/Arsrapport_FOTO_2014_final_anonymiseret.pdf(accessed 3 August 2017)."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-437"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4001"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2007.05.004"},{"key":"e_1_2_10_18_1","unstructured":"The Danish Health Research Committees. Available online at:http:\/\/www.nvk.dk\/english\/the-system-of-health-research-ethics-committees(accessed 4 September 2017)."},{"key":"e_1_2_10_19_1","unstructured":"The Danish Data Protection Agency. Available online at:https:\/\/www.datatilsynet.dk\/english\/health-research-and-statistics-projects\/private-research-and-statistics-projects\/(accessed 4 September 2017)."},{"key":"e_1_2_10_20_1","unstructured":"Danish National Board of Health.Vejledning og redeg\u00f8relse: Pr\u00e6natal genetisk information r\u00e5dgivning og unders\u00f8gelse. [Guideline and report on prenatal genetic information counseling and examination].Copenhagen:Danish National Board of Health 1994."},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.1999.780406.x"},{"key":"e_1_2_10_22_1","first-page":"4409","article-title":"Ultralydunders\u00f8gelse af gravide kvinder i Danmark 1999\u20132000 \u2013 med beskrivelse af udviklingen siden 1989\u201390. 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(In Danish, abstract available)","volume":"165","author":"J\u00f8rgensen FS","year":"2003","journal-title":"Ugeskr Laeger"},{"key":"e_1_2_10_24_1","volume-title":"Retningslinjer for fosterdiagnostik","author":"Danish National Board of Health","year":"2017"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441028"},{"key":"e_1_2_10_26_1","doi-asserted-by":"crossref","DOI":"10.1002\/uog.17683","article-title":"Chromosomal microarray as a primary diagnostic genomic tool for pregnancies defined as being at increased risk within a population based combined first\u2010trimester screening program","author":"Vogel I","year":"2017","journal-title":"Ultrasound Obstet Gynecol"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/cge.12479"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2011.119"},{"key":"e_1_2_10_29_1","first-page":"A5359","article-title":"The rate of invasive testing for trisomy 21 is reduced after implementation of NIPT","volume":"64","author":"Bjerregaard L","year":"2017","journal-title":"Dan Med J"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5093"},{"key":"e_1_2_10_31_1","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/aogs.12581","article-title":"The Danish Fetal Medicine Database: establishment, organization and quality assessment of the first trimester screening program for trisomy 21 in Denmark 2008\u20102012","volume":"96","author":"Ekelund CK","year":"2015","journal-title":"Acta Obstet Gynecol Scand"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faogs.13273","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13273","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T20:50:55Z","timestamp":1695847855000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,22]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1111\/aogs.13273"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13273","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,22]]},"assertion":[{"value":"2017-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-11-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}