Department of Pediatrics, Division of Genetics and Metabolism, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Department of Medicine, Division of Cardiovascular Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Matern Child Health J. 2023 Jun;27(6):978-983. doi: 10.1007/s10995-023-03640-5. Epub 2023 Mar 25.
Familial hypercholesterolemia (FH) is an inherited disease which causes premature atherosclerotic cardiovascular disease. However, less than 10% of individuals with FH have been identified.
To assess parental perspectives for inclusion of FH on routine newborn screening (NBS) and to highlight potential benefits, harms, and ethical concerns.
Telephone interviews of two groups were conducted: 1) parents of children diagnosed with FH, and 2) parents of children diagnosed with a genetic condition through NBS. Stratified purposive sampling was used to ensure adequate representation. The 11 telephone interviews were conducted in 30-min sessions guided by a semi-structured interview script. At the beginning of the interview, participants were educated on the NBS process and FH. The interviews were transcribed verbatim, and a thematic analysis was performed in multiple steps.
All interviewees indicated that they would be interested in having their child be screened for FH on the newborn screen. Reasons supporting screening during the newborn period included knowing their child's diagnosis, the ability to screen family members for FH, incorporation of lifestyle changes, and access to preventive care. Negatives surrounding screening during the newborn period included increased stress or anxiety, knowledge, stigma, and the delay from diagnosis to initiation of pharmacotherapy for FH.
While these interviewees were in favor of NBS for FH, further education of parents and clinicians is needed to ensure proper implementation. The results of this study may be useful to formulate family notification and care protocols for newborns diagnosed with FH and other diseases.
家族性高胆固醇血症(FH)是一种遗传性疾病,可导致早发性动脉粥样硬化性心血管疾病。然而,只有不到 10%的 FH 患者被确诊。
评估父母对将 FH 纳入常规新生儿筛查(NBS)的看法,并强调潜在的益处、危害和伦理问题。
对两组进行了电话访谈:1)FH 患儿的父母,2)通过 NBS 确诊遗传疾病患儿的父母。采用分层目的抽样法以确保充分的代表性。11 次电话访谈在 30 分钟的会议中进行,会议由半结构化访谈脚本指导。访谈开始时,参与者接受了关于 NBS 流程和 FH 的教育。访谈逐字记录,并进行了多步骤的主题分析。
所有受访者均表示,他们有兴趣让孩子在新生儿筛查中接受 FH 筛查。支持新生儿期筛查的原因包括了解孩子的诊断、筛查 FH 家庭成员的能力、实施生活方式改变以及获得预防保健。在新生儿期进行筛查的负面影响包括增加的压力或焦虑、知识、污名和 FH 药物治疗开始前的诊断延迟。
尽管这些受访者赞成 NBS 筛查 FH,但需要进一步对父母和临床医生进行教育,以确保正确实施。本研究的结果可能有助于为确诊 FH 和其他疾病的新生儿制定家庭通知和护理方案。