Skip to main content
SpringerLink
Log in

Implementing Group Prenatal Counseling for Expanded Noninvasive Screening Options

  • Original Research
  • Published:
Journal of Genetic Counseling

Abstract

Recently, practices have begun integrating cell-free DNA-based noninvasive prenatal screening as a screening option for a variety of genetic conditions. According to the National Society of Genetic Counselors, the integration of cfDNA screening into clinical prenatal practice may "significantly shift the paradigm of prenatal testing and screening for all women." The purpose of this study was to determine whether group information sessions can feasibly serve as an alternative to extended one-on-one genetic counseling for the increasing number of women making decisions about prenatal testing and screening. This study assessed the effect of group genetic information sessions coupled with abbreviated counseling on pregnant women’s knowledge about and attitudes toward prenatal testing and screening.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  • ACOG. (2016). ACOG practice bulletin no. 163: screening for fetal aneuploidy. ACOG.org.

  • ACOG and SMFM. (2016). Ob-Gyns release revised recommendations on screening and testing for genetic disorders. Press Release.

  • ACOG Committee on Practice Bulletins. (2007). ACOG practice bulletin no. 77: screening for fetal chromosomal abnormalities. Obstet Gynecol, 109(1), 217–227.

  • American Board of Genetic Counseling. (2016). About ABGC. Available From: www.abgc.net .

  • Benn, P., Cuckle, H., & Pergament, E. (2012). Non-invasive prenatal diagnosis for down syndrome: The paradigm will shift, but slowly. Ultrasound Obstet Gynecol, 39(2), 127–130. https://doi.org/10.1002/uog.11083.

    Article  PubMed  CAS  Google Scholar 

  • Bryant, A. S., Norton, M. E., Nakagawa, S., Bishop, J. T., Pena, S., Gregorich, S. E., & Kuppermann, M. (2015). Variation in women's understanding of prenatal testing. Obstetrics & Gynecology, 125(6), 1306–1312.

  • Bureau of Labor Statistics USDoL. (2015). Occupational outlook handbook, 2016–2017 edition 2015. Available From www.bls.gov .

  • Bureau USC. (2016). FFF: Women's history month: March 2016. Available From www.census.gov .

  • Chervenak, F. A., McCullough, L. B., Sharma, G., Davis, J., & Gross, S. (2008, 199). Enhancing patient autonomy with risk assessment and invasive diagnosis: an ethical solution to a clinical challenge. American Journal of Obstetrics and Gynecology, (1), 19–e1 Retrieved from Google Scholar.

  • Colicchia, L. C., Holland, C. L., Tarr, J. A., Rubio, D. M., Rothenberger, S. D., & Chang, J. C. (2016). Patient--Health care provider conversations about prenatal genetic screening: recommendation or personal choice. Obstetrics & Gynecology, 127(6), 1145–1152 Retrieved from Google Scholar.

    Article  Google Scholar 

  • Constantine, M., Allyse, M., Rockwood, T., Wall, M., & De Vries, R. (2014). Imperfect informed consent for prenatal screening: lessons from the quad screen. Clinical Ethics, 9(1), 17–27.

  • Devers, P., Cronister, S., Ormond, K., Facio, F., Brasington, C., & Flodman. (2013). Noninvasive prenatal testing/noninvasive prenatal diagnosis: the position of the national society of genetic counselors. Journal of Genetic Counseling, 22(3), 291–295.

    Article  PubMed  Google Scholar 

  • Dondorp, W., de Wert, G., Bombard, Y., Bianchi, D. W., Bergmann, C., Borry, P., et al. (2015). Non-invasive prenatal testing for aneuploidy and beyond: challenges of responsible innovation in prenatal screening. Eur J Hum Genet. https://doi.org/10.1038/ejhg.2015.57.

  • Farrell, R. M., Nutter, B., & Agatisa, P. K. (2015). Patient-centered prenatal counseling: aligning obstetric healthcare professionals with needs of pregnant women. Women & Health 55(3):280–96. Retrieved from Google Scholar.

  • Farrell, R. M., Agatisa, P. K., Mercer, M. B., Mitchum, A., & Coleridge, M. (2016a). The use of noninvasive prenatal testing in obstetric care: educational resources, practice patterns, and barriers reported by a national sample of clinicians. Prenatal Diagnosis. https://doi.org/10.1002/pd.4812.

  • Farrell, R. M., Agatisa, P. K., Mercer, M. B., Mitchum, A., & Coleridge, M. (2016b). The use of noninvasive prenatal testing in obstetric care: educational resources, practice patterns, and barriers reported by a national sample of clinicians. Prenatal Diagnosis 36(6):499–506.

  • Gregg, A. R., Skotko, B. G., Benkendorf, J. L., Monaghan, K. G., Bajaj, K., Best, R. G., et al. (2016). Noninvasive prenatal screening for fetal aneuploidy, 2016 update: a position statement of the american college of medical genetics and genomics. Genet Med, 18(10), 1056–1065.

  • Harris, R. A., Washington, A. E., Feeny, D., & Kuppermann, M. (2001). Decision analysis of prenatal testing for chromosomal disorders: what do the preferences of pregnant women tell us? Genetic Testing, (5, 1), 23–32 Retrieved from Google Scholar.

  • Horsting, J. M., Dlouhy, S. R., Hanson, K., Quaid, K., Bai, S., & Hines, K. A. (2014). Genetic counselors' experience with cell-free fetal DNA testing as a prenatal screening option for aneuploidy. Journal of Genetic Counseling, 23, 377–400. https://doi.org/10.1007/s10897-013-9673-4.

    Article  PubMed  Google Scholar 

  • Hui, L., Teoh, M., da Silva Costa, F., Ramsay, P., Palma-Dias, R., Richmond, Z., et al. (2014). Clinical implementation of cell-free DNA based aneuploidy screening: perspectives from a national audit. Ultrasound Obstet Gynecol. https://doi.org/10.1002/uog.14699.

  • Hunter, A. G. W., Cappelli, M., Humphreys, L., Allanson, J. E., Chiu, T. T., Peeters, C., et al. (2005). A randomized trial comparing alternative approaches to prenatal diagnosis counseling in advanced maternal age patients. Clinical Genetics, 67(4), 303–313 Retrieved from Google Scholar.

    Article  PubMed  CAS  Google Scholar 

  • Knutzen, D. M., Stoll, K. A., McClellan, M. W., Deering, S. H., & Foglia, L. M. (2013). Improving knowledge about prenatal screening options: can group education make a difference? The Journal of Maternal-Fetal & Neonatal Medicine, 26(18), 1799–1803.

    Article  Google Scholar 

  • Larion, S., Warsof, S. L., Romary, L., Mlynarczyk, M., Peleg, D., & Abuhamad, A. Z. (2014). Association of combined first-trimester screen and noninvasive prenatal testing on diagnostic procedures. Obstetrics & Gynecology, 123(6), 1303–1310 Retrieved from Google Scholar.

    Article  Google Scholar 

  • Minkoff, H., & Berkowitz, R. (2014). The case for universal prenatal genetic counseling. Obstet Gynecol, 123(6), 1335–1338. https://doi.org/10.1097/AOG.0000000000000267.

    Article  PubMed  Google Scholar 

  • Musci, T. J., Fairbrother, G., Batey, A., Bruursema, J., Struble, C., & Song, K. (2013). Non-invasive prenatal testing with cell-free DNA: US physician attitudes toward implementation in clinical practice. Prenatal Diagnosis, 33(5), 424–428. https://doi.org/10.1002/pd.4091.

    Article  PubMed  Google Scholar 

  • Pain, E. (2016). Genetic counseling: A growing area of opportunity. Science. Jun. 13, 2016, http://www.sciencemag.org/careers/2016/06/genetic-counseling-growingarea-opportunity.

  • Pan, V., Yashar, B. M., Pothast, R., & Wicklund, C. (2016). Expanding the genetic counseling workforce: program directors’ views on increasing the size of genetic counseling graduate programs. Genetics in Medicine, 18(8), 842–849.

  • Roche, M. I., & Greb, A. E. (2016). It’s time to ramp up genetic counseling training. Genetics in Medicine, 18(8), 768–769.

  • Sachs, A., Blanchard, L., Buchanan, A., Norwitz, E., & Bianchi, D. W. (2015). Recommended pre-test counseling points for noninvasive prenatal testing using cell-free DNA: a 2015 perspective. Prenatal Diagnosis, 35(10), 968–971 Retrieved from Google Scholar.

    Article  PubMed  Google Scholar 

  • Shieh, C., Mays, R., McDaniel, A., & Yu. (2009). Health literacy and its association with the use of information sources and with barriers to information seeking in clinic-based pregnant women. Health Care for Women International, 30(11), 971–988.

    Article  PubMed  Google Scholar 

  • SMFM. (2014). Cell free DNA is not a simple blood test. SMFM.org - the Society for Maternal Fetal Medicine, Publications and Guidelines.

  • Suskin, E., Hercher, L., Aaron, K. E., & Bajaj, K. (2016). The integration of noninvasive prenatal screening into the existing prenatal paradigm: a survey of current genetic counseling practice. Journal of Genetic Counseling, 25(5), 1032–1043.

  • Thompson, S., Noblin, S. J., Lemons, J., Peterson, S. K., Carreno, C., & Harbison, A. (2015). Perceptions of latinas on the traditional prenatal genetic counseling model. Journal of Genetic Counseling, 24(4), 675–682 Retrieved from Google Scholar.

    Article  PubMed  Google Scholar 

  • Wax, J. R., Cartin, A., Chard, R., Lucas, F. L., & Pinette, M. G. (2015). Noninvasive prenatal testing: impact on genetic counseling, invasive prenatal diagnosis, and trisomy 21 detection. Journal of Clinical Ultrasound, 43(1), 1–6 Retrieved from Google Scholar.

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Sarah Jenkins for her statistical assistance in visualizing the survey results.

Author information

Authors and Affiliations

  1. Biomedical Ethics Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Betsy L. Gammon & Megan Allyse

  2. Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA

    Laura Otto, Myra Wick & Megan Allyse

  3. Medical Genetics, Mayo Clinic, Rochester, MN, USA

    Myra Wick

  4. Maternal Fetal Medicine, Mayo Clinic, Rochester, MN, USA

    Kristy Borowski

Authors
  1. Betsy L. Gammon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laura Otto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Myra Wick
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kristy Borowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Megan Allyse
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Megan Allyse.

Ethics declarations

Conflict of Interest

Elizabeth Gammon, Kristy Borowski, Myra Wick, Megan Allyse declare no conflict of interest.

Human Studies and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Animal Studies

No animal studies were carried out by the authors for this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gammon, B.L., Otto, L., Wick, M. et al. Implementing Group Prenatal Counseling for Expanded Noninvasive Screening Options. J Genet Counsel 27, 894–901 (2018). https://doi.org/10.1007/s10897-017-0178-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10897-017-0178-4

Keywords

Search

Navigation