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Am J Epidemiol 2003; 158:509-511.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

Invited Commentary: Parity and the Risk of Down’s Syndrome—Caution in Interpretation

Annabelle Chan 

From the Pregnancy Outcome Unit, Epidemiology Branch, South Australian Department of Human Services, Adelaide, South Australia 5000, Australia.

Received for publication April 17, 2003; accepted for publication April 22, 2003.

Abbreviations: Abbreviation: BERD, Birth Events Record Database.

The first 150 words of the full text of this article appear below.


   INTRODUCTION
 
The paper by Doria-Rose et al. (1) in this issue of the Journal examines parity as an independent risk factor for Down’s syndrome. Birth certificate and Birth Events Record Database (BERD) hospital inpatient information for Washington State for the period 1984–1998 was used in a case-control study with exact matching on maternal age. Doria-Rose et al. found an increasing risk of Down’s syndrome with increasing parity. A word of caution is needed in interpreting the results of their study.

It is well-known that risk of a Down’s syndrome pregnancy increases with maternal age (2, 3). Since the 1970s, pregnant women aged 35 years or more have been offered amniocentesis and karyotyping of their fetuses so they can have the option of terminating the pregnancy if Down’s syndrome is detected. Chorionic villus sampling for detection of fetal Down’s syndrome became available during the mid-1980s; it has . . . [Full Text of this Article]

Inclusion of terminations for Down’s syndrome
Ascertainment of Down’s syndrome births
Lesser use of prenatal diagnosis by women of high parity
"Error" which may be introduced by inclusion of pregnancy terminations in the analysis

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Related articles in Am. J. Epidemiol.:

Parity and the Risk of Down’s Syndrome
V. Paul Doria-Rose, Han S. Kim, Elizabeth T. J. Augustine, and Karen L. Edwards
Am. J. Epidemiol. 2003 158: 503-508. [Abstract] [FREE Full Text]  

Doria-Rose and Edwards Respond to "Parity and Down’s Syndrome"
V. Paul Doria-Rose and Karen L. Edwards
Am. J. Epidemiol. 2003 158: 512-513. [Extract] [FREE Full Text]  



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V. P. Doria-Rose and K. L. Edwards
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