Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Genet Med. 2013 Feb;15(2):139-45. doi: 10.1038/gim.2012.113. Epub 2012 Sep 6.
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.
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.
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.
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.
基因组微阵列可以检测到常规细胞遗传学无法检测到的拷贝数变异。尽管许多拷贝数变异的临床意义目前尚不清楚,但这项技术正在迅速扩散到产前环境中。我们进行了一项定性试点研究,以探讨在研究环境中接受产前微阵列检测异常结果的女性的经历。
参与者是参与多中心前瞻性研究“基于阵列的拷贝数分析的产前细胞遗传学诊断”的女性的一部分。对 23 名接受异常产前微阵列结果的女性进行了电话访谈。
我们发现,有五个关键因素主导了接受异常产前微阵列结果的女性的经历:一个好得难以置信的提议、对结果感到惊讶、不确定性和不可量化的风险、需要支持以及毒性知识。
随着产前微阵列检测的使用越来越多,不确定的发现将很常见,因此需要更仔细的检测前和检测后咨询,以及对提供者进行更多的教育和资源,以便他们能够充分支持接受检测的女性。