Lewis Sharon, Curnow Lisette, Ross Margaret, Massie John
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia.
J Paediatr Child Health. 2006 Sep;42(9):533-7. doi: 10.1111/j.1440-1754.2006.00917.x.
To investigate parental attitudes to cystic fibrosis (CF) carrier detection of their infant by newborn screening (NBS).
Data were collected from a postal questionnaire sent to parents of infants identified as CF carriers by NBS in 1996-1997 (inclusive) and 2001 in Victoria, Australia (n = 66).
Almost all parents remembered their child being identified as a CF carrier (97%: 1996/1997; 100%: 2001); yet the majority were unaware at the time that NBS could detect carriers (70%: 1996/1997; 49%: 2001). More parents in the later cohort reported having carrier testing compared with the earlier cohort (85% and 53% respectively) but recall was more uncertain in the earlier cohort when validated against health records. Cascade testing was not utilised frequently by other family members in either cohort. Residual risk of being a carrier if testing was negative was not well understood by parents. Some parents (28%: 1996/1997; 18%: 2001) had residual anxiety about the current health of their carrier child and their future reproductive decision making. Most parents were satisfied with the information provided to them at the time of the sweat test. Few differences were seen between the cohorts.
Although the NBS process for CF in Victoria is working efficiently for the majority of families whose infant is identified as a carrier there are areas that can be improved. We recommend that greater attention should be given to informing parents that a consequence of NBS is CF carrier detection and strategies to improve utilisation of cascade testing should be developed.
调查父母对通过新生儿筛查(NBS)检测其婴儿是否为囊性纤维化(CF)携带者的态度。
数据收集自1996 - 1997年(含)及2001年在澳大利亚维多利亚州通过NBS被确定为CF携带者的婴儿的父母所填写的邮寄调查问卷(n = 66)。
几乎所有父母都记得他们的孩子被确定为CF携带者(1996/1997年为97%;2001年为100%);然而,大多数父母当时并不知道NBS可以检测出携带者(1996/1997年为70%;2001年为49%)。与早期队列相比,后期队列中有更多父母报告进行了携带者检测(分别为85%和53%),但根据健康记录验证时,早期队列的回忆更不确定。两个队列中的其他家庭成员都不经常进行级联检测。父母对检测结果为阴性时仍有携带风险的理解并不充分。一些父母(1996/1997年为28%;2001年为18%)对其携带CF基因的孩子目前的健康状况以及未来的生育决策仍有担忧。大多数父母对汗液测试时提供给他们的信息感到满意。两个队列之间几乎没有差异。
尽管维多利亚州针对CF的NBS流程对大多数其婴儿被确定为携带者的家庭来说运作有效,但仍有一些方面可以改进。我们建议应更加重视告知父母NBS的一个结果是CF携带者检测,并应制定提高级联检测利用率的策略。