ArticleCMAJ open
Rates of prenatal screening across health care regions in Ontario, Canada: a retrospective cohort study.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Equity in prenatal healthcare services globally: an umbrella review.BMC pregnancy and childbirth · 2024Pooled it
- First-Trimester Screening Program for the Risk of Pre-eclampsia Using a Multiple-Marker Algorithm: A Health Technology Assessment.Ontario health technology assessment series · 2023Pooled it
- Carrier Screening Programs for Cystic Fibrosis, Fragile X Syndrome, Hemoglobinopathies and Thalassemia, and Spinal Muscular Atrophy: A Health Technology Assessment.Ontario health technology assessment series · 2023Pooled it
- Uptake of prenatal syphilis screening and its determinants in Ontario, Canada: a population-based retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- Suboptimal screening and correction of maternal iron deficiency anaemia in the general population and in inherited bleeding disorders: A population-based cohort study.British journal of haematology · 2026Article
- Article
- Experiences of perinatal genetic screening for people from migrant and refugee backgrounds: a scoping review.European journal of human genetics : EJHG · 2025Article
- Article
- Addressing fragmented early pregnancy care in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- Genome-Wide Copy Number Variant and High-Throughput Transcriptomics Analyses of Placental Tissues Underscore Persisting Child Susceptibility in At-Risk Pregnancies Cleared in Standard Genetic Testing.International journal of molecular sciences · 2022Article
- Rising syphilis rates in Canada, 2011-2020.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2022Article
- Article
- Racial variations of adverse perinatal outcomes: A population-based retrospective cohort study in Ontario, Canada.PloS one · 2022Article
- Data Resource Profile: Better Outcomes Registry & Network (BORN) Ontario.International journal of epidemiology · 2021Article
- Uptake of fetal aneuploidy screening after the introduction of the non-invasive prenatal test: A national population-based register study.Acta obstetricia et gynecologica Scandinavica · 2021Article
- Comparison of adverse perinatal outcomes between Asians and Caucasians: a population-based retrospective cohort study in Ontario.BMC pregnancy and childbirth · 2021Article
- Caucasian and Asian difference in role of type 1 diabetes on large-for-gestational-age neonates.BMJ open diabetes research & care · 2020Article
- Incidence, Risk Factors, and Mortality Associated With Orofacial Cleft Among Children in Ontario, Canada.JAMA network open · 2020Article
- Prenatal Biochemical Screening and a Woman's Long-Term Risk of Cancer: A Population-Based Cohort Study.JNCI cancer spectrum · 2020Article
- Racial/ethnic variations in gestational weight gain: a population-based study in Ontario.Canadian journal of public health = Revue canadienne de sante publique · 2019Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is recommended that all pregnant women be offered screening for Down syndrome and open neural tube defects, but emerging prenatal tests that are not publicly insured may compromise access. We evaluated screening rates for publicly insured screening tests across health care regions in the province of Ontario and determined whether maternal, provider or regional characteristics are associated with screening uptake.
methodsWe conducted a population-based retrospective cohort study involving pregnant women in Ontario who were at or beyond 16 weeks' gestation in 2007-2009. We ascertained prenatal screening rates using linked health administrative and prenatal screening datasets. We examined maternal, provider and regional characteristics associated with screening uptake. Rate ratios (RRs) were estimated.
resultsOf the 264 737 women included in the study, 62.2% received prenatal screening; uptake varied considerably by region (range 27.8%-80.3%). A greater proportion of women initiated screening in the first rather than the second trimester (50.0% v. 12.2%). Factors associated with lower screening rates included living in a rural area versus an urban area (adjusted rate ratio 0.64, 95% confidence interval [CI] 0.63-0.66), receiving first-trimester care from a family physician or midwife versus an obstetrician (adjusted rate ratio 0.91, 95% CI 0.90-0.92, and 0.40, 95% CI 0.38-0.43, respectively) and being in a lower income quintile (adjusted RR for lowest v. highest 0.95, 95% CI 0.94-0.96). Being an immigrant or a refugee was associated with higher screening rates.
interpretationThere were significant maternal, provider and regional differences in the uptake of prenatal screening across the province. With discrepancies expected to increase with the emergence of noninvasive prenatal tests paid for out of pocket by many women, policy efforts to reduce barriers to prenatal screening and optimize its availability are warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.