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