Demographic factors for utilization of invasive genetic testing after multifetal pregnancy reduction.
OBJECTIVE
Pregnant infertility patients are commonly old enough to be offered prenatal diagnosis. However, they may be reluctant to undergo an additional invasive procedure. We, therefore, sought to determine what demographic factors, including race and ethnic group, influenced patients' decisions to undergo genetic testing in addition to multifetal pregnancy reduction (MFPR).


METHODS
We retrospectively reviewed MFPR patients from July 1997 to June 1999 at our institution. Invasive genetic testing was routinely discussed. Maternal age, race, ethnicity, religion, egg source for in vitro fertilization (IVF) patients, and the remaining fetuses following MFPR were analyzed for invasive genetic testing determinants and were compared to our experiences with genetic referents to us for singleton pregnancies. 132 consecutive patients, of whom 49 were >/=35 years, including 15 having IVF with donor eggs, were included.


RESULTS
Maternal age was the single most significant determinant of testing. In donor egg cases, donor age was significant. Ethnic background, previous children, and the remaining number of fetuses after MFPR were also significant determinants.


CONCLUSIONS
MFPR patients share similar demographics to the advanced maternal age population. Despite the very stressful situations, our data suggest that maternal age, and therefore genetic risk, is the most important determinant of choosing whether or not to have testing. However, patients' decisions are, to varying degrees, modified by religious and ethnic considerations.
Baker
Carol L
CL
Department of Obstetrics and Gynecology, MCP Hahnemann University, Philadelphia, Pa. 19102, USA. obchair@drexel.edu
Feldman
Baruch
B
Shalhoub
Alex G
AG
Ayoub
Melissa A
MA
Krivchenia
Eric L
EL
Yaron
Yuval
Y
Evans
Mark I
MI
D000328:Adult; D003710:Demography; D005006:Ethnicity; D005260:Female; D005817:Genetic Counseling; D005821:Genetic Techniques / Q000706:statistics & numerical data*; D006801:Humans; D008423:Maternal Age; D008824:Michigan; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal / Q000009:adverse effects; D011272:Pregnancy, Multiple; D011296:Prenatal Diagnosis / Q000009:adverse effects / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012449:Safety; D014019:Tissue Donors