title: Prenatal genetic counseling referrals for advanced maternal age:  still room for improvement.
abstract: OBJECTIVE
  The objective of this study is to evaluate genetic risks already present before pregnancy in a cohort of pregnant women referred for prenatal genetic counseling exclusively for advanced maternal age (AMA).
  
  
  METHODS
  We retrospectively reviewed the records of 1353 women referred over 1 year (2010) for pre-test genetic counseling with the only indication of AMA at three Italian Clinical Genetic Services.
  
  
  RESULTS
  Of the 1353 women fulfilling the inclusion criteria of the study, 87 (6.4%) had cumulatively 94 genetic risk factors not previously identified (one risk factor in 80 patients and two risk factors in seven). Twenty-six risk factors (27.7%) concerned heterogeneous or multifactorial conditions and 68 (72.3%) Mendelian or chromosomal disorders and consanguinity.In nine out of these 87 women, the estimated risk for the offspring of a genetic disease or a significant structural anomaly was >5%. Additional testing according to the identified risks was performed in 36 of these 87 women/families.
  
  
  CONCLUSIONS
  The proportion of cases with additional risk factors is smaller than reported in previous studies, but it remains substantial and confirms the need for strategies to increase awareness of the public and health professionals responsible for the care of women in childbearing age.
authors.forename: E
authors.initials: E
authors.lastname: Pompilii
authors.forename: G
authors.initials: G
authors.lastname: Astolfi
authors.forename: O
authors.initials: O
authors.lastname: Calabrese
authors.forename: E
authors.initials: E
authors.lastname: Calzolari
authors.forename: A
authors.initials: A
authors.lastname: Ferlini
authors.forename: M
authors.initials: M
authors.lastname: Lucci
authors.forename: G
authors.initials: G
authors.lastname: Parmeggiani
authors.forename: M
authors.initials: M
authors.lastname: Seri
authors.forename: A
authors.initials: A
authors.lastname: Baroncini
mesh_terms: D000328:Adult; D025063:Chromosome Disorders / Q000235:genetics; D003241:Consanguinity; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing; D006801:Humans; D007558:Italy; D008423:Maternal Age; D010375:Pedigree; D011247:Pregnancy; D011248:Pregnancy Complications / Q000235:genetics; D011296:Prenatal Diagnosis; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires