Q. Who should get prenatal genetic counseling?
A. There are many reasons that women and couples receive prenatal genetic counseling, either before pregnancy to understand any risk of genetic abnormalities, or during pregnancy to understand the health status of the fetus. Pregnant women are referred to genetic counselors if routine screening tests are positive for abnormalities like Down syndrome, but genetic counseling can also be useful for anyone with a higher risk of passing along an inherited disease or experiencing an abnormal outcome in pregnancy. “Anything but routine and average,” says Aubrey Milunsky, founder and co-director of the non-profit Center for Human Genetics, Inc.
A woman’s age is a factor (women over 35 have a higher risk of giving birth to a baby with a genetic disorder), along with health status, exposure to harmful substances, a history of miscarriages, or a family history of an inherited disease or birth defect. Certain ethnic backgrounds are associated with a higher risk of specific genetic disorders. Milunsky said there are now more than 2,500 disorders that can be diagnosed with a genetic test, and couples are increasingly seeking counseling about disorders that emerge in adulthood that they want to avoid passing on to a child.
As it becomes easier to test for genetic disorders, counseling can help couples interpret risks and uncertainties and make decisions about additional testing, medical interventions, or pregnancy termination.