Hopes And Concerns Rise Amid Increased Use Of Fetal DNA Testing, Washington Post Reports

Main Category: Pregnancy / Obstetrics
Also Included In: Genetics;  Abortion;  Women's Health / Gynecology
Article Date: 28 Oct 2008 - 7:00 PDT

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New DNA tests to screen fetuses for a wider array of genetic abnormalities early in pregnancy are raising some hopes as well as concerns that the "flood of murky, misleading results" could lead to more abortions and "needlessly alarm" many people, the Washington Post reports. According to the Post, the tests -- called comparative genomic hybridization -- use gene chips, or "microarrays," to search for deletions or additions of genetic material that can lead to less common, but often more severe, syndromes that are commonly missed by standard genetic analysis.

Supporters of the testing, which costs about $1,600 and is not yet covered by insurance, argue that the results can lessen the future parents' worries or identify abnormalities early enough to terminate the pregnancy or prepare for an infant with special needs. However, critics argue that the tests could increase unnecessary worries in parents, lead to termination of healthy pregnancies or potentially be used to "vet" fetuses for other characteristics, such as personality, intelligence or beauty, the Post reports. Leslie Biesecker of the National Human Genome Research Institute said the testing is a "classic Pandora's box," adding that it "solves some problems while at the same time creating new ones. How you use a powerful technology decides whether it's good or bad."

According to the Post, missing or additional DNA does not always indicate a severe syndrome and additional DNA can often lead to mild or barely noticeable versions of a syndrome. Biesecker said that there is a large number of variations in DNA that might not cause any consequence and are "part of what makes us different," adding that the "trick is, you have to distinguish whether it's going to cause any disorder. We're not there yet."

Ronald Wapner of Columbia University is leading a $3.3 million study funded by the federal government to evaluate the technology in 4,000 pregnancies. Many physicians said the DNA tests should not be offered widely until after the study is released. Baylor College of Medicine and Signature Genomic Laboratories, which are participating in the study, are publicly promoting the tests, while Emory University, another study participant, has "quietly" begun performing the tests, the Post reports.

Arthur Beaudet, chair of Baylor's Department of Molecular and Human Genetics, said the testing is "ready for prime time," adding that the testing is the "best option" for people "who want the best possible diagnosis and want the maximum information." He also said that many of the genetic disorders the tests can detect, which include ones that cause physical deformities, mental retardation and health and behavioral problems, "are quite burdensome" and "can have a major impact on the family." If the DNA tests produce unclear results, they are followed up with additional testing, and parents and their physicians receive additional counseling to make sure they understand the results, Beaudet said.

David Prentice of the Family Research Council said the "question is, what is the information used for? If it's for informing parents so they can be prepared for what might come, that's great. But if it's being used for eugenics purposes -- for abortion -- we would be against it." Andrew Imparato, president of the American Association of People with Disabilities, said, "We want disabled children to be welcomed into the world. My fear is we're moving in the opposite direction" and "saying that certain types of lives aren't worth living" (Stein, Washington Post, 10/26).

In related news, the Wall Street Journal on Saturday ran two articles examining advances in prenatal genetic testing. The first article examined the more common microarray technology and a potential noninvasive blood test that can diagnose the health of the fetus (Naik, Wall Street Journal, 10/25). The second article profiled a couple who discovered through prenatal genetic testing that their son had autosomal recessive polycystic kidney disease (Naik, Wall Street Journal, 10/25).

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