Genetics of Learning Disability, Hunter Genetics, Waratah, NSW, Australia.
Am J Med Genet A. 2013 Feb;161A(2):301-11. doi: 10.1002/ajmg.a.35752. Epub 2013 Jan 9.
Although fragile X syndrome (FXS) is the commonest cause of inherited intellectual disability the mean age of diagnosis in Australia is 5.5 years. Newborn screening for FXS can provide an early diagnosis, preventing the "diagnostic odyssey", allowing access to early interventions, and providing reproductive information for parents. Parents of affected children support newborn screening, but few clinical studies have evaluated community attitudes. A pilot study in 2009-2010 was performed in a tertiary hospital to explore feasibility and maternal attitudes. FXS testing of male and female newborns was offered to mothers in addition to routine newborn screening. Mothers were provided with information about FXS, inheritance pattern, carrier status, and associated adult-onset disorders. One thousand nine hundred seventy-one of 2,094 mothers (94%) consented to testing of 2,000 newborns. 86% completed the attitudinal survey and 10% provided written comments. Almost all parents (99%) elected to be informed of both premutation and full mutation status and there was little concern about identification of carrier status or associated adult-onset disorders. Most mothers (96%) were comfortable being approached in the postnatal period and supported testing because no extra blood test was required. Mothers considered an early diagnosis beneficial to help prepare for a child with additional needs (93%) and for reproductive planning (64%). Some were anxious about the potential test results (10%) and others felt their feelings towards their newborn may change if diagnosed with FXS (16%). High participation rates and maternal attitudes indicate a high level of maternal acceptance and voluntary support for newborn screening for FXS.
尽管脆性 X 综合征(FXS)是最常见的遗传性智力障碍原因,但在澳大利亚,平均诊断年龄为 5.5 岁。FXS 的新生儿筛查可以提供早期诊断,避免“诊断之旅”,使患儿能够及早接受干预,并为父母提供生殖信息。受影响儿童的父母支持新生儿筛查,但很少有临床研究评估社区态度。2009-2010 年在一家三级医院进行了一项试点研究,以探讨其可行性和母亲的态度。除了常规的新生儿筛查外,还向母亲提供 FXS 男性和女性新生儿的检测。向母亲提供有关 FXS、遗传模式、携带者状态和相关成人发病障碍的信息。在 2094 名母亲中,有 1971 名(94%)同意对 2000 名新生儿进行检测。86%的母亲完成了态度调查,10%的母亲提供了书面意见。几乎所有的父母(99%)都选择了解前突变和全突变状态,而且对识别携带者状态或相关的成人发病障碍几乎没有担忧。大多数母亲(96%)愿意在产后阶段接受询问,并支持检测,因为不需要额外的血液检测。母亲们认为早期诊断有助于为有额外需求的孩子(93%)和生殖计划(64%)做好准备。一些母亲对潜在的测试结果感到焦虑(10%),另一些母亲则担心如果被诊断为 FXS,她们对新生儿的感觉可能会改变(16%)。高参与率和母亲的态度表明,母亲对 FXS 的新生儿筛查接受度和自愿支持程度很高。