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Lessons learned from a prenatal diagnosis program for thalassemia in Thailand
Author(s) -
Wong Peerapon,
Suannum Pawanrat,
Jermnim Sawichayaporn,
Charoenporn Prissana,
ChanIn Monthira,
Tapprom Akamon,
Deoisares Rawisut
Publication year - 2020
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.5723
Subject(s) - medicine , prenatal diagnosis , thalassemia , prenatal screening , pediatrics , obstetrics , gestational age , medical record , pregnancy , gynecology , fetus , surgery , genetics , biology
Abstract Objective To assess the outcome of a thalassemia screening program at community hospitals by determining the proportion of at‐risk couples able to obtain a prenatal diagnosis (PND) in relation to gestational age (GA). Methods We accessed records documenting prenatal screening for thalassemia in lower northern Thailand between January 2014 and December 2016. The proportion of at‐risk pregnancies able to obtain a PND was determined and median GAs at the time of at‐risk notification were compared. Reasons for failures to obtain PNDs were analyzed. Results Among 4633 screen‐positive couples, 259 (5.6%) were identified as at‐risk while 23 were excluded due to unconfirmed outcomes. Forty‐one declined a PND and were excluded from the final calculations. Of the 195 remaining couples, 140 (71.8%) obtained a PND. Their median GA at the time of at‐risk notification was 12.4 (5.6‐29.1) weeks, which was earlier than the median GA of 17.7 (6.9‐34.6) weeks for couples not undergoing PND (P < .001). Risks for various types of thalassemia and GA were associated with the chances of achieving a PND. Conclusion In practice, one quarter of couples identified as at‐risk were unable to obtain a PND. Time‐influencing factors seem to be a major determinant.