Lori Carpenter
Capstone Project Committee: Martha Decker, MD, Sonja Eubanks, MS, CGC, Sat Gupta, PhD (Statistical Consultant), Saju Joy, MD, Randi Stewart, MS, CGC
Prenatal screening and diagnostic testing are ways of identifying fetuses at an increased risk for or who have a genetic condition. Recent recommendations published by the American College of Obstetricians and Gynecologists (ACOG) in January of 2007 updated the previous guidelines, now supporting prenatal screening and diagnostic testing being offered to all pregnant women, regardless of age. In addition, a number of new screening options have become available in recent years. Now there are more screening tests available for patients and their providers. We undertook this study to identify the prenatal screening and diagnostic testing practices of obstetricians in North Carolina to evaluate if the new ACOG Practice Bulletins have resulted in changes in practice. A total of 1,033 surveys were sent to obstetrician-gynecologists currently licensed to practice in North Carolina by email (649) or standard mail (384). The overall response rate was 17.4%. The survey included questions about demographics, which testing options are offered, to whom the tests are offered, what indications warrant a referral for a genetics consult, and established policies. Results indicate that the majority (85.4%) of obstetrician-gynecologists are offering screening to women of all ages and 61% are offering diagnostic testing to women of all ages. However, a variety of screening and testing strategies were reported and described. This suggests that while the majority are following the recommended ACOG guidelines, there are significant differences between practices regarding which screening strategies are employed and to whom. Therefore, it may be beneficial to consider efforts directed towards consistency in the practice of prenatal screening in the state of North Carolina.