title: Prognostic dilemmas and genetic counseling for prenatally detected fragile X gene expansions.
abstract: With widespread adoption of fragile X carrier screening in pregnant women, the number of expectant couples receiving news of an unanticipated Fragile X Mental Retardation 1 (FMR1) gene expansion has increased. The most common abnormal result from maternal FMR1 testing involves an intermediate allele, also known as a gray zone result, which requires genetic counseling but poses minimal risk for an adverse developmental outcome. By contrast, the finding of a maternal FMR1 premutation or full mutation during pregnancy has important implications for the woman herself, her unborn child, and her extended family. These multiple levels of impact, in addition to the complex inheritance pattern and variable expressivity of fragile X-associated disorders, cause significant stress for newly identified expectant couples and pose unique challenges for genetic counselors in the prenatal setting. © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Autism & Developmental Medicine Institute, Geisinger Health System, Lewisburg, PA, USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Finucane
authors.affiliation: Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Sharyn
authors.initials: S
authors.lastname: Lincoln
authors.affiliation: Genomic Medicine Institute, Geisinger Health System, Danville, PA, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Bailey
authors.affiliation: Autism & Developmental Medicine Institute, Geisinger Health System, Lewisburg, PA, USA.
authors.forename: Christa Lese
authors.initials: CL
authors.lastname: Martin
mesh_terms: D000328:Adult; D042622:DNA Repeat Expansion; D005260:Female; D051860:Fragile X Messenger Ribonucleoprotein 1 / Q000235:genetics*; D005600:Fragile X Syndrome / Q000175:diagnosis / Q000235:genetics*; D005817:Genetic Counseling; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis
chemical_list: D051860:Fragile X Messenger Ribonucleoprotein 1; C497683:FMR1 protein, human