{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T13:12:33Z","timestamp":1776949953082,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,5,12]],"date-time":"2014-05-12T00:00:00Z","timestamp":1399852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Israel Notional Institute of Health Policy Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Risk for foetal <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>own syndrome (<jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content>) increases as maternal age increases. Non\u2010invasive screening (maternal serum triple test) for <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> is routinely offered to pregnant women to provide risk estimates and suggest invasive amniocentesis for definitive pre\u2010natal diagnosis to high\u2010risk women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We examined women's decision process with regard to pre\u2010natal screening, and specifically, the degree to which they take into account triple serum screening results when considering whether or not to undergo amniocentesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Semi\u2010structured phone interviews were conducted to assess recall of <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> screening results, understanding of risk estimates and their effect on women's decision whether to undergo amniocentesis. The study included 60 pregnant <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>sraeli women (half younger than 35 and half advanced maternal age \u2013 <jats:styled-content style=\"fixed-case\">AMA<\/jats:styled-content>), with normal <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> screening results and no known ultrasound abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Age appeared to determine the decision process. The vast majority of <jats:styled-content style=\"fixed-case\">AMA<\/jats:styled-content> women had amniocentesis, many of them before receiving their <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> screening results. Most <jats:styled-content style=\"fixed-case\">AMA<\/jats:styled-content> participants knew that their risk estimate was \u2018normal\u2019, but still considered themselves at high risk due to their age. Procedure\u2010related risk (miscarriage) and other factors only had a minor effect on their decision. A minority of younger women had amniocentesis. Younger women mentioned procedure\u2010related risk and having normal screening results as the main factors affecting their decision not to have amniocentesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Age 35 is an anchor for the pre\u2010determination regarding performing or avoiding amniocentesis. <jats:styled-content style=\"fixed-case\">AMA<\/jats:styled-content> women mention \u2018age\u2019 as their main reason to have amniocentesis and considered it an independent risk factor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.12200","type":"journal-article","created":{"date-parts":[[2014,5,12]],"date-time":"2014-05-12T07:28:51Z","timestamp":1399879731000},"page":"2306-2317","source":"Crossref","is-referenced-by-count":18,"title":["Factors that affect the decision to undergo amniocentesis in women with normal Down syndrome screening results: it is all about the age"],"prefix":"10.1111","volume":"18","author":[{"given":"Julia","family":"Grinshpun\u2010Cohen","sequence":"first","affiliation":[{"name":"The Danek Gertner Institute of Human Genetics Sheba Medical Center Tel Hashomer Israel"},{"name":"Sakler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Talya","family":"Miron\u2010Shatz","sequence":"additional","affiliation":[{"name":"Center for Medical Decision Making Ono Academic College Kiryat Ono Israel"},{"name":"Center for Medicine in the Public Interest New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liat","family":"Ries\u2010Levavi","sequence":"additional","affiliation":[{"name":"The Danek Gertner Institute of Human Genetics Sheba Medical Center Tel Hashomer Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elon","family":"Pras","sequence":"additional","affiliation":[{"name":"The Danek Gertner Institute of Human Genetics Sheba Medical Center Tel Hashomer Israel"},{"name":"Sakler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,5,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10897-005-9014-3"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320030202"},{"key":"e_1_2_7_4_1","first-page":"253","article-title":"Clients' interpretation of risks provided in genetic counseling","volume":"39","author":"Wertz DC","year":"1989","journal-title":"American Journal of Human Genetics"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870448908400365"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/10810730903032986"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548509708400572"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e3181cef9e1"},{"key":"e_1_2_7_9_1","first-page":"282","article-title":"Rates of chromosomal abnormalities at different maternal ages","volume":"58","author":"Hook EB","year":"1981","journal-title":"Obstetrics and Gynecology"},{"key":"e_1_2_7_10_1","first-page":"72","article-title":"A prospective evaluation of a second\u2010trimester screening test for fetal Down syndrome using maternal serum alpha\u2010fetoprotein, hCG, and unconjugated estriol","volume":"81","author":"Cheng EY","year":"1993","journal-title":"Obstetrics and Gynecology"},{"key":"e_1_2_7_11_1","unstructured":"Israeli Ministry of Health policy statement 2007; 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