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Prognostic dilemmas and genetic counseling for prenatally detected fragile X gene expansions
Author(s) -
Finucane Brenda,
Lincoln Sharyn,
Bailey Lindsay,
Martin Christa Lese
Publication year - 2017
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4963
Subject(s) - fragile x syndrome , genetic counseling , fmr1 , expressivity , pregnancy , fragile x , allele , genetic testing , prenatal diagnosis , genetics , medicine , psychology , fetus , pediatrics , psychiatry , gene , biology
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.