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All Pregnancies Should be Screened for Down Syndrome

By Karen Barrow

All pregnant women should be screened for Down syndrome, regardless of age, according to new guidelines from the American College of Obstetricians and Gynecologists.

Previously, only women over the age of 35 and those at particularly high risk were advised to undergo testing for the chromosomal abnormalities that cause birth defects such as Down syndrome in a fetus. But these new guidelines cite improved, less invasive screening methods as a rationale behind testing all pregnant women for these potential problems.

"Screening tests have gotten much better and more sensitive," said Dr. James Goldberg, an Ob/Gyn from the San Francisco Perinatal Associates. The improved sensitivity of the screening tests means that they are more likely than older tests to find an abnormality when one is present.

Down syndrome is the most common genetic abnormality, affecting one out of every 800 babies. It is caused by a genetic abnormality that results in a person being born with three copies of chromosome 21 or an extra piece of this chromosome instead of the usual two. This abnormality causes moderate or severe mental retardation, distinctive facial features and a higher risk for heart defects.

For decades, only women over the age of 35 were routinely offered screening tests for this and other chromosomal abnormalities for two specific reasons: older mothers are at a greater risk of giving birth to a baby with a genetic abnormality and the most reliable screenings tests, such as amniocentesis, are invasive (requiring that a needle be inserted into the pregnant women's uterus), so using them in younger women put the mother and fetus at an unnecessary risk for complications from the procedure itself.
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