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Monday, January 26, 2004Statistically, the odds of a 35-year-old woman having a miscarriage following amniocentesis are 1 in 200, as is the likelihood of her having a child with Down syndrome or another chromosomal abnormality. The older a woman, the greater her risk of having a genetically abnormal child. In a previous study, published in 2000 in the journal Obstetrics and Gynecology, the researchers discovered that for most of the women surveyed, the anxiety about having a child with Down syndrome outweighed the fear of a miscarriage. In the new study, the researchers quantify their earlier conclusion by arguing that the provision of such amniocentesis information to pregnant women of all ages is cost-effective. Thus, from now on, doctors advising pregnant females, no matter how young, should inform them of the availability of amniocentesis as a way of determining their babies' genetic risks, said study chief Dr. Miriam Kuppermann, of the University of California at San Francisco, in a telephone interview. 'Prenatal diagnostic testing should be offered to pregnant women irrespective of maternal age or risk,' the study says." Here's how the study decided that universal amniocentesis was cost effective: In the USA, compared with no diagnostic testing, amniocentesis costs less than US$15 000 per quality-adjusted life year gained for women of all ages and risk levels. The results do not depend on maternal age or risk of Down's syndrome-affected birth. The cost-utility ratio for any individual woman depends on her preferences for reassurance about the chromosomal status of her fetus, and, to a lesser extent, for miscarriage. And how do you measure "quality-adjusted life year gained"? How many "quality-adjusted life years" do you lose if your chormosomally normal baby grows up to be a juvenile delinquent? Or to develop a post-natal medical problem? How many "quality-adjusted" years do you gain if you have a child with Down's syndrome and discover that you love them and enjoy being with them? And is one "quality-adjusted life year" really worth $15,000? Seems a rather high price just for the alleviation of pregnancy jitters. posted by Sydney on 1/26/2004 08:13:00 AM 0 comments 0 Comments: |
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