Bogue Lauren, Peay Holly, Martin Ann, Lucas Ann, Ramchandren Sindhu
Department of Neurology, University of Michigan, Ann Arbor, MI 48105, USA; Parent Project Muscular Dystrophy, Hackensack, NJ 07601, USA.
Parent Project Muscular Dystrophy, Hackensack, NJ 07601, USA; RTI International, Durham, NC 27709, USA.
Neuromuscul Disord. 2016 Dec;26(12):860-864. doi: 10.1016/j.nmd.2016.09.008. Epub 2016 Sep 16.
Our study objective was to survey female carriers for Duchenne and Becker muscular dystrophy to identify barriers to carrier testing and the impact of carrier risk knowledge on cardiac and reproductive health management. We surveyed women who have or had biological sons with Duchenne or Becker muscular dystrophy and were enrolled in the US DuchenneConnect patient registry, with questions assessing knowledge of carrier status and recurrence risk, knowledge of care standards for carriers, and barriers to testing. Of the 182 eligible respondents, 25% did not know their carrier status and 14% incorrectly classified themselves as not at risk. Cost of testing was the most commonly identified barrier to testing. Women reporting unknown carrier status were 13 times as likely to express uncertainty regarding their recurrence risk compared to women reporting positive carrier status. 37% of women at an increased risk for cardiomyopathy had never had an echocardiogram. Women who were certain of their positive carrier status were twice as likely to have had an echocardiogram in the last five years compared to women with unknown carrier status. Future research on reducing barriers to counseling and carrier testing, such as cost, may improve care standard adherence.
我们的研究目标是对杜氏和贝克型肌营养不良症的女性携带者进行调查,以确定携带者检测的障碍以及携带者风险知识对心脏和生殖健康管理的影响。我们对那些有或曾有患杜氏或贝克型肌营养不良症亲生子且已加入美国杜氏连接患者登记处的女性进行了调查,询问了她们关于携带者状态和复发风险的知识、携带者护理标准的知识以及检测的障碍。在182名符合条件的受访者中,25%不知道自己的携带者状态,14%将自己错误地归类为无风险。检测费用是最常被提及的检测障碍。报告携带者状态未知的女性表达其复发风险不确定性的可能性是报告携带者状态为阳性的女性的13倍。37%患心肌病风险增加的女性从未做过超声心动图检查。与携带者状态未知的女性相比,确定自己为阳性携带者状态的女性在过去五年中做过超声心动图检查的可能性是前者的两倍。未来关于减少咨询和携带者检测障碍(如费用)的研究可能会提高对护理标准的依从性。