Women's experiences receiving abnormal prenatal chromosomal microarray testing results

被引:178
作者
Bernhardt, Barbara A. [1 ,2 ]
Soucier, Danielle [2 ]
Hanson, Karen [3 ]
Savage, Melissa S. [3 ]
Jackson, Laird [4 ]
Wapner, Ronald J. [3 ]
机构
[1] Univ Penn, Dept Med, Philadelphia, PA 19104 USA
[2] Univ Penn, Ctr Integrat Genet Healthcare Technol, Philadelphia, PA 19104 USA
[3] Columbia Univ, Coll Phys & Surg, Dept Obstet & Gynecol, New York, NY USA
[4] Drexel Univ, Coll Med, Dept Obstet & Gynecol, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
genetic counseling; microarray testing; prenatal diagnosis; qualitative research; COMPARATIVE GENOMIC HYBRIDIZATION; DIAGNOSIS; DECISION; PARENTS; ROUTINE; INFORMATION; TECHNOLOGY; CONTINUE; ISSUES; CARE;
D O I
10.1038/gim.2012.113
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Purpose: Genomic microarrays can detect copy-number variants not detectable by conventional cytogenetics. This technology is diffusing rapidly into prenatal settings even though the clinical implications of many copy-number variants are currently unknown. We conducted a qualitative pilot study to, explore the experiences of women receiving abnormal results from prenatal microarray testing performed in a research setting. Methods: Participants were a subset of women participating in a multicenter prospective study "Prenatal Cytogenetic Diagnosis by Array-based Copy Number Analysis." Telephone interviews were conducted with 23 women receiving abnormal prenatal microarray results. Results: We found that five key elements dominated the experiences of women who had received abnormal prenatal microarray results: an offer too good to pass up, blindsided by the results, uncertainty and unquantifiable risks, need for support, and toxic knowledge. Conclusion: As prenatal microarray testing is increasingly used, uncertain findings will be common, resulting in greater need for careful pre- and posttest counseling, and more education of and resources for providers so they can adequately support the women who are undergoing testing. Genet Med 2013:15(2):139-145
引用
收藏
页码:139 / 145
页数:7
相关论文
共 39 条
[11]   "Did you find that out in time?": New life trajectories of parents who choose to continue a pregnancy where a genetic disorder is diagnosed or likely [J].
Hickerton, Chriselle L. ;
Aitken, MaryAnne ;
Hodgson, Jan ;
Delatycki, Martin B. .
AMERICAN JOURNAL OF MEDICAL GENETICS PART A, 2012, 158A (02) :373-383
[12]   Family-centered care in the context of fetal abnormality [J].
Howard, Elisabeth D. .
JOURNAL OF PERINATAL & NEONATAL NURSING, 2006, 20 (03) :237-242
[13]   The routine and the traumatic in prenatal genetic diagnosis:: does clinical information inform patient decision-making? [J].
Hunt, LM ;
de Voogd, KB ;
Castañeda, H .
PATIENT EDUCATION AND COUNSELING, 2005, 56 (03) :302-312
[14]   The at-risk health status and technology: A diagnostic invitation and the 'gift' of knowing [J].
Kenen, RH .
SOCIAL SCIENCE & MEDICINE, 1996, 42 (11) :1545-1553
[15]   Does informed decision making influence psychological outcomes after receiving a positive screening outcome? [J].
Kleinveid, Johanna H. ;
ten Kate, Leo P. ;
van den Berg, Matthijs ;
van Vugt, John M. G. ;
Timmermans, Danielle R. M. .
PRENATAL DIAGNOSIS, 2009, 29 (03) :271-273
[16]   Recasting Hope: A process of adaptation following fetal anomaly diagnosis [J].
Lalor, Joan ;
Begley, Cecily M. ;
Galavan, Eoin .
SOCIAL SCIENCE & MEDICINE, 2009, 68 (03) :462-472
[17]   Clinical utility of array comparative genomic hybridisation for prenatal diagnosis: a cohort study of 3171 pregnancies [J].
Lee, C-N ;
Lin, S-Y ;
Lin, C-H ;
Shih, J-C ;
Lin, T-H ;
Su, Y-N .
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2012, 119 (05) :614-625
[18]   From Karyotyping to Array-CGH in Prenatal Diagnosis [J].
Lichtenbelt, K. D. ;
Knoers, N. V. A. M. ;
Schuring-Blom, G. H. .
CYTOGENETIC AND GENOME RESEARCH, 2011, 135 (3-4) :241-250
[19]   PRENATAL GENETIC TESTING AND GENETICIZATION - MOTHER MATTERS FOR ALL [J].
LIPPMAN, A .
FETAL DIAGNOSIS AND THERAPY, 1993, 8 :175-188
[20]   Array-based technology and recommendations for utilization in medical genetics practice for detection of chromosomal abnormalities [J].
Manning, Melanie ;
Hudgins, Louanne .
GENETICS IN MEDICINE, 2010, 12 (11) :742-745