Do, Phuc
(2022)
Survey of the Genetic Counselor Perspective Regarding the 2020 ACOG Guideline Update Recommending the Routine Offering of NIPT in All Pregnancies.
Master's Thesis, University of Pittsburgh.
(Unpublished)
Abstract
Traditionally, Non-Invasive Prenatal Testing (NIPT) is offered to high-risk pregnancies to screen for chromosomal abnormalities. In 2020, the American College of Obstetricians and Gynecologists (ACOG) issued a guideline update that recommended routine offering of NIPT in all pregnancies. However, some studies showed concerns over the universal offering of NIPT citing challenges in informed consent, patients’ lack of awareness of possible outcomes, and insurance coverage.
Genetic counselors play an important role in pre- and post-test counseling to facilitate decision-making for patients when considering NIPT. This study surveyed genetic counselors’ perspectives regarding the ACOG updated guidelines and aspects surrounding NIPT counseling. The survey was distributed through the listservs of the National Society of Genetic Counselors (NSGC) in two weekly digest emails of October and November 2021.
Out of approximately 850 practicing prenatal genetic counselors, 72 responses were recorded (a 8.9% response rate). Per results, NIPT was deeply integrated into prenatal genetic counseling with high familiarity of the ACOG update. Most genetic counselors (81.25%) are offering NIPT to all patients. Top factors that support offering NIPT to all patients were departmental decision (31.03%), professional opinion (34.48%), and the impact of the ACOG guidelines (26.72%). Lack of insurance coverage and challenges in informed consent were stated as common barriers of universal NIPT screening.
There is a consensus among genetic counselors that patients considering NIPT should be given anticipatory guidance regarding the test’s nuances, and that such information was needed to achieve informed consent. Furthermore, there is a strong need for patient friendly resources on NIPT, with the most popular topics being differentiating between diagnostics and screening and the possibility of different types of atypical results.
This study provided insights from the genetic counselor community regarding different aspects of NIPT counseling in ACOG guideline implementation. In terms of public health, this survey results called for additional patient friendly NIPT resources and inspired a creation of a factsheet that addresses patients’ need according to genetic counselors’ perspectives. The challenges in universal NIPT offering need to be researched and addressed for appropriate and ethical guideline implementation.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
1 July 2022 |
| Date Type: |
Publication |
| Defense Date: |
9 June 2022 |
| Approval Date: |
1 July 2022 |
| Submission Date: |
24 June 2022 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
100 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Genetic Counseling
School of Public Health > Public Health Genetics |
| Degree: |
MS - Master of Science |
| Thesis Type: |
Master's Thesis |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
"prenatal screening" "NIPT" "genetic counseling" "genetic counselor" "survey" "ACOG" "universal NIPT screening" |
| Date Deposited: |
01 Jul 2022 18:45 |
| Last Modified: |
01 Jul 2022 18:45 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/43230 |
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