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在加利福尼亚州洛杉矶的一家公立医院完成指定的父亲产前基因检测和携带者检测。

The completion of indicated paternal prenatal genetic and carrier testing at a public hospital in Los Angeles, California.

作者信息

Nguyen Michelle T, Mazza Genevieve, Nguyen Brian T

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA.

Division of Family Planning, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA.

出版信息

Genet Med Open. 2023 Sep 1;1(1):100831. doi: 10.1016/j.gimo.2023.100831. eCollection 2023.

Abstract

PURPOSE

Pregnant individuals are routinely advised to undergo genetic carrier screening, followed by carrier screening in the reproductive partner if the patient's screen is positive. The objective of our study was to identify completion rates of and barriers to partner carrier screening or genetic testing.

METHODS

We conducted a retrospective cohort study examining the completion of indicated partner genetic screening or testing at the Los Angeles General Medical Center Genetics clinic from January 1, 2017, to October 31, 2022. We examined factors linked to completing partner genetic screening or testing, including sociodemographic factors for patients and their partners, testing indications, and pregnancy characteristics via bivariate analyses (eg, test, χ, and Fisher's exact tests).

RESULTS

In this primarily low-income, publicly insured, Spanish-speaking population, we identified 98 pregnancies for which partner genetic screening or testing was indicated. Only 26.5% ( = 26) completed testing, which did not vary by indication, parental age, parental race, parity, or primary language. Completion of partner genetic screening or testing was significantly linked to earlier gestational age at referral for genetic counseling (19.1 versus 21.5 weeks,  = .006). In 4 cases, being unable to obtain partner test results led to invasive diagnostic testing of the pregnant patient.

CONCLUSION

Less than one-third of pregnancies received indicated partner genetic screening or testing. Early referral to genetic counseling may improve partner testing completion rates, which could avoid invasive and unnecessary diagnostic testing in the pregnant patient.

摘要

目的

通常建议孕妇进行基因携带者筛查,若患者筛查结果为阳性,则其生殖伴侣也需进行携带者筛查。我们研究的目的是确定伴侣携带者筛查或基因检测的完成率及障碍。

方法

我们进行了一项回顾性队列研究,调查了2017年1月1日至2022年10月31日在洛杉矶综合医疗中心遗传学诊所进行指定伴侣基因筛查或检测的完成情况。我们通过双变量分析(如检验、χ²检验和费舍尔精确检验)研究了与完成伴侣基因筛查或检测相关的因素,包括患者及其伴侣的社会人口学因素、检测指征和妊娠特征。

结果

在这个主要为低收入、有公共保险、讲西班牙语的人群中,我们确定了98例需要进行伴侣基因筛查或检测的妊娠。只有26.5%(n = 26)完成了检测,且完成率在检测指征、父母年龄、父母种族、产次或主要语言方面没有差异。伴侣基因筛查或检测的完成与转诊进行遗传咨询时的孕周较早显著相关(19.1周对21.5周,P = .006)。在4例病例中,无法获得伴侣检测结果导致对孕妇进行了侵入性诊断检测。

结论

不到三分之一的妊娠进行了指定的伴侣基因筛查或检测。早期转诊进行遗传咨询可能会提高伴侣检测的完成率,从而避免对孕妇进行侵入性且不必要的诊断检测。

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