Determinates of underutilization of amniocentesis among Israeli Arab women

Objectives: To study the determinants of amniocentesis underutilization among Israeli Arab Muslim women. Methods: Pregnant women referred for amniocentesis (n = 476) were identified through family health centers (FHCs). Data on sociodemographic characteristics, knowledge of prenatal testing, and attitudes toward termination of pregnancy (TOP) were collected through interviews and from medical records. Results: Of all women eligible for amniocentesis free of charge, only 17.9% (95% CI: 14.7-21.6) underwent the test. Women referred as a result of advanced maternal age underwent the test less often than those referred for other indications [13.5% and 25.0%, respectively, (p = 0.002)]. In multivariate analyses, determinants for amniocentesis underutilization among women referred for advanced maternal age were: being religious [OR 2.71 (95% CI 1.04-7.01)], perceiving amniocentesis a risky procedure [OR 3.25 (95% CI 1.28-8.20)], spouse's opposing TOP [OR 3.73 (95% CI 1.48-9.37)], less advanced age [OR 0.74 (95% CI 0.58-0.94)] and being a housewife [OR 2.59 (95% CI 0.96-6.95)]. In women referred for other reasons poor accessibility [OR 5.49 (95% CI 1.50-20.05)], perceiving amniocentesis a risky procedure [OR 3.45 (95% CI 1.17-10.17)] and spouse's opposing TOP [OR 7.47 (95% CI 2.46-22.63)] were the significant determinants. Conclusions: Any program aimed at increasing amniocentesis uptake among Muslim women should be directed to both partners and should emphasize the low risk for miscarriage following the test.