Characteristics of first-trimester screening of non-responders in a high-uptake population

Our aim was to compare demographic, social and reproductive health-related medical factors between women who did and women who did not undergo combined first-trimester screening (cFTS) and to examine their reasons for declining a screening offer, especially whether non-participation was an informed choice.

This was a nationwide survey conducted in Denmark in 2014. A structured questionnaire with 33 questions relating to demographical data and medical history was mailed to 1,495 randomly selected women who gave birth in 2012. Half of the women were selected among the population without cFTS, the other half from those with cFTS. A cohort of 20 women tested the questionnaire for consistency. The results are based on the responders (58%).

The response rate was 88% among the women with cFTS and 19% among the women without. Not having a cFTS performed was associated with the following factors: country of origin other than Denmark (p < 0.01), less education (p < 0.01) and unemployment (p < 0.01). These women more often had a religious belief (p < 0.01), and had undergone fewer induced abortions (p = 0.01). They felt less informed about the cFTS (p < 0.01) and thought it was a more difficult decision (p < 0.01) than the women who had undergone cFTS. The main reason for declining cFTS was a wish to keep the child regardless of any cFTS results (82%).

Women without cFTS differ from those who undergo cFTS. Not undergoing cFTS seemed most often to be the result of a conscious choice based on ethical considerations, rather than being the result of a lack of information. However, a low response rate decreases the strength of our conclusions.

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