Department of Pediatrics, MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois 60637, USA.
J Natl Med Assoc. 2009 Nov;101(11):1163-72. doi: 10.1016/s0027-9684(15)31113-5.
In the United States, newborn screening programs universally identify newborns with sickle cell disease (SCD) and heterozygote carriers (sickle cell trait [SCT]). Although there is a consensus to disclose SCT to parents, there are limited empirical data about whether and how this information is transmitted to the carrier children.
In-person questionnaires were administered to parents with SCT and parents of a child with either SCD or SCT to examine the knowledge, attitudes, beliefs, and disclosure patterns about SCT of parents.
Fifty-three adults were interviewed, half (27) of whom had a child with SCD. There was significant misunderstanding about sickle cell inheritance (mean score, 68%), but parents who have a child with SCD have better knowledge compared to those without a child with SCD (78% vs 58%, p = .002). Respondents perceive minimal stigma associated with SCT. Unless there is an affected proband, individuals with SCT rarely receive counseling or education outside of the family.
There is significant misinformation about what it means to be a carrier and its health and reproductive implications. Formal professional counseling is rare, especially for those families without an affected proband. Strategies to increase the utilization of counseling and improve genetic literacy are necessary.
在美国,新生儿筛查计划普遍识别出患有镰状细胞病(SCD)和杂合子携带者(镰状细胞特征[SCT])的新生儿。尽管已经达成共识,要向父母透露 SCT,但关于是否以及如何向携带者儿童传达此信息的经验数据有限。
对 SCT 父母和患有 SCD 或 SCT 的儿童的父母进行了面对面的问卷调查,以检查父母对 SCT 的知识、态度、信念和披露模式。
对 53 位成年人进行了访谈,其中一半(27 位)的孩子患有 SCD。关于镰状细胞遗传的误解非常严重(平均得分为 68%),但与没有 SCD 孩子的父母相比,有 SCD 孩子的父母的知识更丰富(78%比 58%,p=0.002)。受访者认为 SCT 关联的耻辱感很小。除非有受影响的先证者,否则 SCT 个体很少在家庭之外接受咨询或教育。
关于成为携带者及其健康和生殖影响意味着什么,存在重大误解。正规的专业咨询很少见,尤其是对于那些没有受影响先证者的家庭。有必要采取策略来增加咨询的利用和提高遗传素养。