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Published in: Journal of Genetic Counseling 4/2017

01-08-2017 | Original Research

Experiences among Women with Positive Prenatal Expanded Carrier Screening Results

Authors: Erin Rothwell, Erin Johnson, Amber Mathiesen, Kylie Golden, Audrey Metcalf, Nancy C. Rose, Jeffrey R. Botkin

Published in: Journal of Genetic Counseling | Issue 4/2017

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Abstract

The offering and acceptance of expanded carrier screening is increasing among pregnant women including women without an increased risk based on race, ethnicity or family history. The chances of a positive screening test have been reported to be as high as 24 % when multiple conditions are screened. Yet, little is known about the way these tests are offered and how patients are affected by a positive test result. To explore this area of genetic testing, interviews (n = 17) were conducted among women who received positive expanded carrier results in the context of obstetric care. A content analysis was conducted on the transcript data from the interviews. Outcomes of this research suggest that educational interventions are needed to improve maternal understanding of positive carrier screening results. Most of the participants in this study confused the results with other prenatal screening test options. In addition, the way the results were discussed varied greatly, and influenced participants’ thoughts about reproductive decisions that led to a range of emotional uncertainty. Our data suggests that genetic counseling improved participants’ understanding of positive results. More research is needed to further understand if our results are consistent within a larger, more diverse sample, and to explore how to best provide education about expanded carrier screening.
Literature
go back to reference Borry, P., Henneman, L., Lakeman, P., ten Kate, L. P., Cornel, M. C., & Howard, H. C. (2011). Preconceptional genetic carrier testing and the commercial offer directly-to-consumers. Human Reproduction (Oxford, England), 26(5), 972–977.CrossRef Borry, P., Henneman, L., Lakeman, P., ten Kate, L. P., Cornel, M. C., & Howard, H. C. (2011). Preconceptional genetic carrier testing and the commercial offer directly-to-consumers. Human Reproduction (Oxford, England), 26(5), 972–977.CrossRef
go back to reference Clayton, E. W., Hannig, V. L., Pfotenhauer, J. P., Parker, R. A., Campbell 3rd, P. W., & Phillips 3rd, J. A. (1995). Teaching about cystic fibrosis carrier screening by using written and video information. American Journal of Human Genetics, 57(1), 171–181.PubMedPubMedCentral Clayton, E. W., Hannig, V. L., Pfotenhauer, J. P., Parker, R. A., Campbell 3rd, P. W., & Phillips 3rd, J. A. (1995). Teaching about cystic fibrosis carrier screening by using written and video information. American Journal of Human Genetics, 57(1), 171–181.PubMedPubMedCentral
go back to reference Darcy, D., Tian, L., Taylor, J., & Schrijver, I. (2011). Cystic fibrosis carrier screening in obstetric clinical practice: knowledge, practices, and barriers, a decade after publication of screening guidelines. Genetic Testing and Molecular Biomarkers, 15(7–8), 517–523. doi:10.1089/gtmb.2010.0228.CrossRefPubMed Darcy, D., Tian, L., Taylor, J., & Schrijver, I. (2011). Cystic fibrosis carrier screening in obstetric clinical practice: knowledge, practices, and barriers, a decade after publication of screening guidelines. Genetic Testing and Molecular Biomarkers, 15(7–8), 517–523. doi:10.​1089/​gtmb.​2010.​0228.CrossRefPubMed
go back to reference Edwards, J. G., Feldman, G., Goldberg, J., Gregg, A. R., Norton, M. E., Rose, N. C., et al. (2015). Expanded carrier screening in reproductive medicine-points to consider: a joint statement of the American College of Medical Genetics and Genomics, American College of Obstetricians and Gynecologists, National Society of genetic counselors, perinatal quality foundation, and Society for Maternal-Fetal Medicine. Obstetrics and Gynecology, 125(3), 653–662. doi:10.1097/aog.0000000000000666.CrossRefPubMed Edwards, J. G., Feldman, G., Goldberg, J., Gregg, A. R., Norton, M. E., Rose, N. C., et al. (2015). Expanded carrier screening in reproductive medicine-points to consider: a joint statement of the American College of Medical Genetics and Genomics, American College of Obstetricians and Gynecologists, National Society of genetic counselors, perinatal quality foundation, and Society for Maternal-Fetal Medicine. Obstetrics and Gynecology, 125(3), 653–662. doi:10.​1097/​aog.​0000000000000666​.CrossRefPubMed
go back to reference Grody, W. W., Thompson, B. H., Gregg, A. R., Bean, L. H., Monaghan, K. G., Schneider, A., & Lebo, R. V. (2013). ACMG position statement on prenatal/preconception expanded carrier screening. Genetics in Medicine, 15(6), 482–483. doi:10.1038/gim.2013.47.CrossRefPubMed Grody, W. W., Thompson, B. H., Gregg, A. R., Bean, L. H., Monaghan, K. G., Schneider, A., & Lebo, R. V. (2013). ACMG position statement on prenatal/preconception expanded carrier screening. Genetics in Medicine, 15(6), 482–483. doi:10.​1038/​gim.​2013.​47.CrossRefPubMed
go back to reference Ioannou, L., McClaren, B. J., Massie, J., Lewis, S., Metcalfe, S. A., Forrest, L., & Delatycki, M. B. (2014). Population-based carrier screening for cystic fibrosis: a systematic review of 23 years of research. Genetics in Medicine, 16(3), 207–216. doi:10.1038/gim.2013.125.CrossRefPubMed Ioannou, L., McClaren, B. J., Massie, J., Lewis, S., Metcalfe, S. A., Forrest, L., & Delatycki, M. B. (2014). Population-based carrier screening for cystic fibrosis: a systematic review of 23 years of research. Genetics in Medicine, 16(3), 207–216. doi:10.​1038/​gim.​2013.​125.CrossRefPubMed
go back to reference Lazarin, G. A., Haque, I. S., Nazareth, S., Iori, K., Patterson, A. S., Jacobson, J. L., et al. (2013). An empirical estimate of carrier frequencies for 400+ causal Mendelian variants: results from an ethnically diverse clinical sample of 23,453 individuals. Genetics in Medicine, 15(3), 178–186. doi:10.1038/gim.2012.114.CrossRefPubMed Lazarin, G. A., Haque, I. S., Nazareth, S., Iori, K., Patterson, A. S., Jacobson, J. L., et al. (2013). An empirical estimate of carrier frequencies for 400+ causal Mendelian variants: results from an ethnically diverse clinical sample of 23,453 individuals. Genetics in Medicine, 15(3), 178–186. doi:10.​1038/​gim.​2012.​114.CrossRefPubMed
go back to reference Lewis, R. (2013). Genetic testing: carrier confusion and genration reversal. DNA Science Blog: Genetics in Context. February 7, 2013. Lewis, R. (2013). Genetic testing: carrier confusion and genration reversal. DNA Science Blog: Genetics in Context. February 7, 2013.
go back to reference Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis. Thousand Oaks, CA: Sage Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis. Thousand Oaks, CA: Sage
go back to reference Ormond, K. E., Iris, M., Banuvar, S., Minogue, J., Annas, G. J., & Elias, S. (2007). What do patients prefer: informed consent models for genetic carrier testing. Journal of Genetic Counseling, 16(4), 539–550. doi:10.1007/s10897-007-9094-3.CrossRefPubMed Ormond, K. E., Iris, M., Banuvar, S., Minogue, J., Annas, G. J., & Elias, S. (2007). What do patients prefer: informed consent models for genetic carrier testing. Journal of Genetic Counseling, 16(4), 539–550. doi:10.​1007/​s10897-007-9094-3.CrossRefPubMed
go back to reference Rothwell, E., Anderson, R., Goldenberg, A., Lewis, M. H., Stark, L., Burbank, M., Wong, B., & Botkin, J. R. (2012). Assessing Public Attitudes on the Retention and Use of Residual Newborn Screening Blood Samples: A Focus Group Study. Social Science & Medicine, 74, 1305–1309. doi:10.1016/j.socscimed.2011.12.047.CrossRef Rothwell, E., Anderson, R., Goldenberg, A., Lewis, M. H., Stark, L., Burbank, M., Wong, B., & Botkin, J. R. (2012). Assessing Public Attitudes on the Retention and Use of Residual Newborn Screening Blood Samples: A Focus Group Study. Social Science & Medicine, 74, 1305–1309. doi:10.​1016/​j.​socscimed.​2011.​12.​047.CrossRef
go back to reference Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health, 23, 334–340.CrossRef Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health, 23, 334–340.CrossRef
go back to reference Warsch, J. R., Warsch, S., Herman, E., Zakarin, L., Schneider, A., Hoffman, J., et al. (2014). Knowledge, attitudes, and barriers to carrier screening for the Ashkenazi Jewish panel: a Florida experience : education and barriers assessment for Jewish genetic diseases. Journal of Community Genetics, 5(3), 223–231. doi:10.1007/s12687-013-0179-4.CrossRefPubMedPubMedCentral Warsch, J. R., Warsch, S., Herman, E., Zakarin, L., Schneider, A., Hoffman, J., et al. (2014). Knowledge, attitudes, and barriers to carrier screening for the Ashkenazi Jewish panel: a Florida experience : education and barriers assessment for Jewish genetic diseases. Journal of Community Genetics, 5(3), 223–231. doi:10.​1007/​s12687-013-0179-4.CrossRefPubMedPubMedCentral
Metadata
Title
Experiences among Women with Positive Prenatal Expanded Carrier Screening Results
Authors
Erin Rothwell
Erin Johnson
Amber Mathiesen
Kylie Golden
Audrey Metcalf
Nancy C. Rose
Jeffrey R. Botkin
Publication date
01-08-2017
Publisher
Springer US
Published in
Journal of Genetic Counseling / Issue 4/2017
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-016-0037-8

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