Attitudes of women of childbearing age towards prenatal diagnosis in Southeastern France

The objective of this study was to explore women's attitudes towards prenatal diagnosis of trisomy 21 and to examine some of the factors possibly responsible for these attitudes before implementing in real practice serological screening of pregnant women at risk for trisomy 21. We carried out a telephone survey on a representative sample of women who had recently had a normal livebirth delivery in the Marseille district in 1990. The participation rate was 80 per cent and the average age of the mothers was 28-9 years. Among the 514 women interviewed, 78 per cent stated that they would ask for an amniocentesis for a 1 per cent risk of trisomy 21 at their next pregnancy. When adjusting for confounding factors, the decision to have or not to have an amniocentesis was found to depend not only on the women's attitude towards induced abortion, but also on their understanding of the risk involved and on the social context (knowing a handicapped child, discussion with the father). It also depended on the women's age and on what they knew about amniocentesis from the medical point of view. The risk of miscarriage can influence a woman's choice but this objection was not found to affect the women's decisions significantly in our survey. The data showed the existence of a high potential demand for fetal karyotyping.     

Prenatal diagnosis of thalidomide syndrome

A case of thalidomide syndrome diagnosed by ultrasound in the 17th week of pregnancy is presented. The pregnant woman had leprosy and received adjuvant treatment with thalidomide. The affected fetus was exposed to the drug until the 35th day of pregnancy and presented absent external ears, upper limb phocomelia and absent tibiae and fibulae. No internal organ abnormalities were noticed at autopsy.     

Emissions associated with meeting the future global wheat demand: A case study of UK production under climate change constraints

Climate change, population growth and socio-structural changes will make meeting future food demands extremely challenging. As wheat is a globally traded food commodity central to the food security of many nations, this paper uses it as an example to explore the impact of climate change on global food supply and quantify the resulting greenhouse gas emissions. Published data on projected wheat production is used to analyse how global production can be increased to match projected demand. The results show that the largest projected wheat demand increases are in areas most likely to suffer severe climate change impacts, but that global demand could be met if northern hemisphere producers exploit climate change benefits to increase production and narrow their yield gaps. Life cycle assessment of different climate change scenarios shows that in the case of one of the most important wheat producers (the UK) it may be possible to improve yields with an increase of only 0.6% in the emission intensity per unit of wheat produced in a 2 °C scenario. However, UK production would need to rise substantially, increasing total UK wheat production emissions by 26%. This demonstrates how national emission inventories and associated targets do not incentivise minimisation of global greenhouse gas emissions while meeting increased food demands, highlighting a triad of challenges: meeting the rising demand for food, adapting to climate change and reducing emissions.