A 25-year-old client at 10 weeks’ gestation comes to the clinic for her first prenatal visit. It is the client’s first pregnancy. The client is concerned about the chances of her child developing Down syndrome. The client’s medical and family history is not remarkable. When the client asks about the risk factors associated with Down syndrome, which of the following statements by the midwife is the most accurate?
  1. “The risk of having a baby with Down syndrome is high in females who got pregnant below the age of 18 years.”
  2. “The age of the father does not affect the child’s risk of developing Down syndrome; it is the age of the mother that mainly influences the child’s risk.”
  3. “Females who have a history of three first trimester spontaneous abortions not due to hormonal deficiencies or incompetent cervix are at risk of having babies with Down syndrome.”
  4. “A female who has a child with Down syndrome neither decreases nor increases her chances of having a child with the same diagnosis.”
Explanation
Answer: C - Females who have a history of three first trimester abortions not due to hormonal deficiencies or incompetent cervix are at risk of having babies with Down syndrome. The risk of the child developing Down syndrome increases with advancing maternal and paternal age. The risk increases when the mother is older than 35 years and the father is older than 55 years at the time of fertilization. A female who has a child with Down syndrome has an increased risk of having another child with the same diagnosis.
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