Author ORCID Identifier

0000-0002-5662-7270

Date of Graduation

5-2017

Document Type

Thesis (MS)

Program Affiliation

Genetic Counseling

Degree Name

Masters of Science (MS)

Advisor/Committee Chair

Claire Singletary, MS CGC

Committee Member

Jennifer Czerwinski, MS CGC

Committee Member

Sandra Darilek, MS CGC

Committee Member

Anthony Johnson, DO

Committee Member

Malorie Jones, MS CGC

Abstract

The rate of twinning is rising and is associated with delayed age at childbirth and increased infertility treatments. Since the introduction of non-invasive prenatal testing, interest in and uptake of genetic screening and testing in twin pregnancies has not been investigated. Therefore, this study aimed to describe the attitudes toward and uptake of current prenatal genetic screening and testing options in twin pregnancies. Forty-two women with twin gestations were recruited from UTHealth and Baylor College of Medicine sites between August 2016 and January 2017 for participation in a descriptive study consisting of a questionnaire (n=42) and semi-structured phone interview (n=15). Descriptive statistics and Fischer’s exact-test were employed for questionnaire analysis. Qualitative data from interviews were analyzed using thematic analysis to identify common themes. Data analysis showed that women were significantly more in favor of screening than diagnostic testing (p = 0.049). Sixty-nine percent elected genetic screening, while only three percent had a diagnostic procedure. Women were interested in screening for preparation or reassurance despite having concerns about accuracy and uncertainty associated with screening in twin pregnancies. Most women (86%) felt they would make the same decision if it were a singleton pregnancy, suggesting that twin pregnancy may not strongly impact decision-making for many women. Despite this, 48% of women cited that being pregnant with twins was still an influencing factor to some degree. Information learned from medical providers, past experiences, and family and friends were also cited as influencing factors, suggesting that tailoring prenatal genetic counseling sessions for twin gestations might parallel that of singletons. Although it did not alter patient decisions for 91% of women, genetic counseling was used as a platform to raise concerns and gather information. No significant differences between natural and assisted conception patients were found; however, further research in this area is necessary given the small sample size.

Keywords

Psychosocial, Qualitative, Twin Pregnancies, Prenatal Genetic Testing, Attitudes

Available for download on Friday, May 04, 2018

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