Norton Mary E, Nakagawa Sanae, Kuppermann Miriam
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, 350 Parnassus Ave, Suite 810, San Francisco, CA 94143-0705, USA.
Kaiser Permanente, San Francisco, CA 94143, USA.
J Clin Med. 2014 Jan 21;3(1):144-52. doi: 10.3390/jcm3010144.
Little is known about women's comparative attitudes towards prenatal testing for different categories of genetic disorders. We interviewed women who delivered healthy infants within the past year and assessed attitudes towards prenatal screening and diagnostic testing, as well as pregnancy termination, for Down syndrome (DS), fragile X (FraX), cystic fibrosis (CF), spinal muscular atrophy (SMA), phenylketonuria (PKU) and congenital heart defects (CHD). Ninety-five women aged 21 to 48 years participated, of whom 60% were Caucasian, 23% Asian, 10% Latina and 7% African American; 82% were college graduates. Ninety-five to ninety-eight percent indicated that they would have screening for each condition, and the majority would have amniocentesis (64% for PKU to 72% for SMA). Inclinations regarding pregnancy termination varied by condition: Whereas only 10% reported they would probably or definitely terminate a pregnancy for CHD, 41% indicated they would do so for DS and 62% for SMA. Most women in this cohort reported that they would undergo screening for all six conditions presented, the majority without the intent to terminate an affected pregnancy. These women were least inclined to terminate treatable disorders (PKU, CHD) versus those associated with intellectual disability (DS, FraX) and were most likely to terminate for SMA, typically lethal in childhood.
关于女性对不同类型遗传疾病产前检测的比较态度,我们所知甚少。我们采访了过去一年中分娩出健康婴儿的女性,并评估了她们对唐氏综合征(DS)、脆性X综合征(FraX)、囊性纤维化(CF)、脊髓性肌萎缩症(SMA)、苯丙酮尿症(PKU)和先天性心脏病(CHD)的产前筛查、诊断检测以及终止妊娠的态度。95名年龄在21至48岁之间的女性参与了调查,其中60%为白人,23%为亚洲人,10%为拉丁裔,7%为非裔美国人;82%拥有大学学历。95%至98%的人表示她们会针对每种疾病进行筛查,并且大多数人会选择羊水穿刺检查(PKU为64%,SMA为72%)。关于终止妊娠的倾向因疾病而异:只有10%的人表示她们可能或肯定会因CHD而终止妊娠,41%的人表示会因DS而终止妊娠,62%的人表示会因SMA而终止妊娠。该队列中的大多数女性表示她们会对列出的所有六种疾病进行筛查,大多数人无意终止受影响的妊娠。这些女性最不愿意终止可治疗的疾病(PKU、CHD),而对于与智力残疾相关的疾病(DS、FraX)则相对更愿意,对于SMA最有可能终止妊娠,SMA通常在儿童期致命。