Impact of prenatal screening on the birth status of fetuses with Down syndrome at an urban hospital, 1972-1994

This hospital-based study has determined the change over time (1972-1974 and 1979-1994) in the methods of prenatal detection of fetuses with Down syndrome and the impact of elective termination on the portion that were liveborn. Using a malformations surveillance program, all 265 affected fetuses and infants were identified among 161,560 births and elective terminations during the aforementioned period at Brigham and Women's Hospital in Boston, MA. From 1972 to 1974, Down syndrome was not diagnosed in any affected infants prenatally. In the early 1980s, amniocentesis was the primary method of diagnosis; later, maternal serum screening and ultrasonography were as likely to be the first method of detection. Most couples (86%) elected to terminate pregnancies with affected fetuses. The effect of prenatal detection and the choice of elective termination produced a significant decrease, between 1972 and 1994, in the portion of fetuses with Down syndrome who were liveborn.