Clinical Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA.
J Assist Reprod Genet. 2022 Mar;39(3):747-755. doi: 10.1007/s10815-022-02430-2. Epub 2022 Feb 11.
Adult-onset disease risks associated with carriers of recessive disease have and will continue to be identified. As carrier screening becomes more broadly utilized, providers face the dilemma of whether they should discuss these risks during discussions with prospective parents. This study aimed to understand whether preconception/prenatal genetic counselors (PPGCs) were aware of the risk of Parkinson disease in carriers of, and persons with, Gaucher disease and the reasons behind choosing whether to discuss this risk with patients.
Eligible participants included board-certified or board-eligible genetic counselors who had counseled preconception/prenatal patients within the past 3 years. An online survey was distributed via the National Society of Genetic Counselors in November of 2017.
One hundred twenty genetic counselors completed the quantitative survey, distributed in Fall of 2017. While the majority of respondents knew of the Gaucher-related Parkinson's link (n = 78; 65%), just over one-third reported discussing it in preconception/prenatal settings (n = 30; 38.5%). Respondents reported discussing these links more consistently when disclosing positive results or when the patient/family approached the topic. Respondents cited the lack of professional guidelines as one of the main reasons for not discussing the link.
These results highlight an inconsistency in PPGCs' discussions of the Parkinson's risk in Gaucher disease carriers, and the need to develop guidelines regarding these issues to help standardize the care and education of patients.
与隐性疾病携带者相关的成人发病疾病风险已经并将继续被识别。随着携带者筛查的广泛应用,提供者面临着是否应该在与潜在父母的讨论中讨论这些风险的困境。本研究旨在了解孕前/产前遗传咨询师 (PPGC) 是否了解戈谢病携带者和患者患帕金森病的风险,以及选择是否与患者讨论这种风险的原因。
合格的参与者包括在过去 3 年内为孕前/产前患者提供咨询的持牌或有资格获得认证的遗传咨询师。2017 年 11 月,通过国家遗传咨询师协会在线分发了一项问卷调查。
120 名遗传咨询师完成了 2017 年秋季的定量调查。虽然大多数受访者都知道与戈谢病相关的帕金森病联系(n=78;65%),但只有超过三分之一的人报告在孕前/产前环境中讨论过(n=30;38.5%)。当披露阳性结果或患者/家属提出该主题时,受访者报告更一致地讨论这些联系。受访者提到缺乏专业指南是不讨论该联系的主要原因之一。
这些结果突出了 PPGC 对戈谢病携带者帕金森病风险讨论的不一致性,并且需要制定有关这些问题的指南,以帮助规范患者的护理和教育。