Wednesday, December 07, 2005

1861 FASTER ways to kill babies

Lots of bloggers noted the study last month in the New England Journal of Medicine about first trimester tests for Down's Syndrome (Vol. 353, no. 19, November 10, 2005, pp. 2001-2011). I didn't get a chance to read the article until today, after I'd checked out the issue to read an article on the dangers of sleep apnea. Anyway, the early test is so parents (are they called parents if the blob of tissue isn't a baby?) can look at strategies to "help guide the choice." The word choice appears in the very last sentence of the article--up to that point, nothing is said about what will be done with the information from the tests.

This article has the most bone-chilling, sanitized medicaleze I've ever read, beginning with the name of the Consortium that performed the study: FASTER stands for First- and Second-Trimester Evaluation of Risk. In short, you can find out earlier (faster) if your baby has Down's. However, there is a greater margin of error--more "false positives" if you rely just on the first trimester test instead of doing it again in the second trimester and comparing results. It is less stressful, I suppose, to kill off a baby before you feel those little ticklish butterfly kisses in your abdomen, but how do you turn off the brain that knows what you are really doing?

Figure 1 in the study charts the women who participated in this study. A total of "42,367 patients were approached for enrollment." Not pregnant women who might be willing to have an abortion given test results faster, but "patients." Not solicited, but "approached." Not scammed, but "enrolled." Well, 4,178 jumped ship right away--they were either ineligible or they refused. Then another 156 had some other, non-Down's problems, so they were dropped. So, 38,033 got this first trimester screening, with 92 revealing Down's Syndrome, which drops to 87 with the second trimester screening. There's other playing with numbers in the table, and I'm not sure what all went on, but having the two tests "is superior for detecting Down's Syndrome." We're not told if the women chose abortion or life for a less than perfect baby, only that this screening is a powerful tool.

[You could all just save yourselves a lot of grief, sorrow and death of babies (remember all those false positives) if you'd have your babies before age 35. In the study, 29,834 of the women were younger than 35, and they had 28 fetuses (i.e. babies) with Down's Syndrome; 8,199 of the women were 35 or older and they had 64. Put the career track on hold instead of the mommy-track.]

And in the small print: Jacob A. Canick, PhD, and Nicholas J. Wald, FRCP, who participated in the study hold U.S. patents for unconjugated estriol as a marker in prenatal screening for Down's syndrome. Mr. Wald holds patents for the screening test using the first and second trimester markers as a single test, and is a director of a company that makes software used to calculate Down's syndrome risk, and is a director of the company which licenses the screening test. Some of the doctors in the study receive lecture fees from various equipment companies used in the study.

1 comment:

Miss Tresninos said...

Having a child with a birth defect I must say that this sort of thing makes me sick. Whenever I hear people talk about "terminating" a child that *might* have something wrong with them I feel like they might as well slap me in the face because they are, essentially, saying that my child's life is not worth anything. Most of the early tests they already have give false positives and yet women act on those to end the life of their child.

I would disagree with the after 35 thing, however. I would love for a new kind of study to be done on that factoring in # of children had prior, etc. All the down's syndrome kids I know have all been born to people who were under the age of 35 at the time. Whereas many people in my family were born after their mothers were 35 (both my grandmothers were born when their mothers were in their 40s) and we have no DS in our family. There just has to be something else involved. (However, I do agree with your assessment of the "career track.")