Genomics for health in preconception and prenatal periods.
OBJECTIVE
To review and report changes in genomic-based knowledge and care during the preconception and prenatal periods.


METHODS
Integrative review of relevant medical and nursing literature.


RESULTS
Client education and counseling are needed to understand genomic information and provide guidance in interpreting this information and making decisions. The factors that influence decision-making about testing and acting on test results constitute a complex process that has not been well studied. Family history is an important tool for obtaining genomic information and can assist women and families in understanding risk preconceptionally and prenatally. Genomic research has enhanced understanding of the mechanisms of birth defects such as neural tube defect and will likely provide research opportunities to better understand complex perinatal outcomes such as preterm birth.


CONCLUSIONS
Research, education, advocacy, and anticipatory guidance are needed as women and families obtain more genetic and genomic information before and during pregnancy. All nurses will be involved in helping patients use genetic and genomic information to understand risk and to develop strategies to modify risk, and in translating the expanding array of genomic information to improve birth outcomes.
Dolan
Siobhan
S
Obstetrics & Gynecology and Women's Health Albert Einstein College of Medicine, Montefiore Medical Center, Belfer 501, 1300 Morris Park Avenue, Bronx, NY 10461, USA. siobhanmdolan@yahoo.com
Biermann
Janis
J
Damus
Karla
K
D025063:Chromosome Disorders / Q000175:diagnosis / Q000235:genetics / Q000517:prevention & control; D003657:Decision Making; D005817:Genetic Counseling / Q000379:methods; D036281:Genetic Research; D005820:Genetic Testing / Q000379:methods; D005826:Genetics, Medical / Q000379:methods; D023281:Genomics / Q000379:methods; D006301:Health Services Needs and Demand; D006801:Humans; D008487:Medical History Taking; D020412:Multifactorial Inheritance / Q000235:genetics; D024802:Nurse's Role; D009730:Nursing Assessment; D015399:Nursing Research; D010344:Patient Advocacy; D010353:Patient Education as Topic; D010375:Pedigree; D016742:Preconception Care / Q000379:methods; D011295:Prenatal Care / Q000379:methods; D011296:Prenatal Diagnosis / Q000379:methods / Q000451:nursing; D018570:Risk Assessment