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Challenging the Strategy of Maternal Age–Based Prenatal Genetic Counseling
Richard L. Berkowitz, MD;
Jaclyn Roberts, MD;
Howard Minkoff, MD
JAMA. 2006;295:1446-1448.
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The decision to offer pregnant women prenatal diagnosis for genetic diseases has long had an age-based trigger.1-2 Early studies convincingly demonstrated an escalating rate of aneuploidy with advancing maternal age,3 but risks related to amniocentesis are independent of maternal age. When the flat risk-line from the invasive diagnostic procedure (iatrogenic pregnancy loss) crossed the age-related ascending risk-line of aneuploidy on a graph of adverse events, an intersection was determined that became the age standard for offering the procedure. Data from the 1970s appeared to suggest that at the age of 35 years a woman had a similar chance of delivering a child with aneuploidy3 as experiencing a miscarriage after an amniocentesis,4 and that age became "the" prompt for genetic counseling.2 Much has been learned since then, but despite the substantially increased efficiency of diagnostic technologies and possibly reduced risks of . . . [Full Text of this Article]Screening for Aneuploidy
Author Affiliations: Departments of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY (Dr Berkowitz), State University of New York Health Science Center at Brooklyn (SUNY Downstate), Brooklyn, NY (Dr Roberts), and Maimonides Medical Center, Brooklyn (Drs Roberts and Minkoff).
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