The ability to spontaneously conceive after 45 years of age is associated with an exceptionally low rate of spontaneous abortions and a distinct pattern of apoptosis/anti apoptosis gene expression pattern

Abstract

CREIGHTON LIKES, LINDSEY METCALF, CURTIS ROGERS, Greenville Hospital System, Center for Women’s Medicine, Greenville, South Carolina, Greenville Hospital System; Maternal-Fetal Medicine, OB/GYN, Greenville, South Carolina, Greenvile Hospital System; Center for Women’s Medicine, OB/GYN, Greenville, South Carolina, Greenville Hospital Center, OB/GYN, Greenville, South Carolina, Greenville Hospital System, Genetics, Greenville, South Carolina OBJECTIVE: To evaluate the effectiveness of cystic fibrosis screening in a resident prenatal clinic. STUDY DESIGN: Following the recommendations of the American College of Obstetricians and Gynecologists, and the American College of Medical Genetics, the Obstetric resident clinic at Greenville Memorial Hospital began offering cystic fibrosis counseling and screening to all patients beginning in July 2002. On each serum sample, 33 different cystic fibrosis mutations were analyzed with detection rates of 90% for North European Caucasians, 69% for AfricanAmericans, and 57% for Hispanics. RESULTS: Over the first two years of the program, 4572 patients were enrolled for prenatal care and 2231 (49%) elected carrier screening at a cost of $200 per patient for a total of $446,200. Of those screened, 1282 were Caucasian, 816 African-American, 106 Hispanic, and 27 others. Fifty-eight patients were found to be positive for cystic fibrosis mutation; 50 were Caucasian, 4 AfricanAmerican, 3 Hispanic, and 1 other. This carrier frequency is in line with what is expected. Nineteen of the expectant fathers elected to have carrier screening after counseling with none being identified as positive. CONCLUSION: Cystic fibrosis may not be prevalent enough to justify the cost of such a screening program in a resident prenatal clinic in the southeast.