Relationship Between Social Determinants of Health and the Thalassemia Prenatal Diagnosis Test in Zahedan, South Eastern Iran.

Little is known about the social determinants of health (SDH) of taking the prenatal diagnosis (PND) test as a pivotal strategy to prevent occurrences of -thalasssemia major (-TM). This study sought to evaluate the relationship between socio-demographic characteristics of parents and taking the PND test at Zahedan, Iran from 2015 to 2016. The design of the present study was a case-control. Data on socio-demographic characteristics of parents including age, education, job, ethnicity, and family relationships, kind of marriage as well as pre marriage test status and PND test status, were obtained from registered medical records. The relationship between socio-demographic characteristics and taking the PND test was evaluated using binary logistic regression. The study included 256 -thalassemia (-thal) carrier couples who were referred to the Zahedan Prenatal Diagnosis Center to take the PND test and 47 -thal carrier couples who already had a newborn with -TM and had not taken the PND test. Univariate analysis showed that the higher education level of the father, consanguineous parents, official marriages, pre marriage test and consultation, significantly increased the odds of taking the PND test. The significant relationships were not observed in multivariable analysis, however, pre marriage tests and official marriages can be considered as determinants of taking the PND test with odds ratio (OR) [95% confidence interval (95% CI)] of 14.67 (0.64, 334.93) and 3.41 (0.55, 20.94), respectively. Our results provided evidence in which socio-demographic characteristics of the parents may determine their taking the PND test.