Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease

Background: Globally, about five per cent of children are born with congenital or genetic disorders. The most common autosomal recessive conditions are thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease, with higher carrier rates in specific patient populations. Identifying and...

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Main Authors: Hussein, Norita, Weng, Stephen F., Kai, Joe, Kleijnen, Jos, Qureshi, Nadeem
Format: Article
Language:English
Published: Wiley 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/50505/
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author Hussein, Norita
Weng, Stephen F.
Kai, Joe
Kleijnen, Jos
Qureshi, Nadeem
author_facet Hussein, Norita
Weng, Stephen F.
Kai, Joe
Kleijnen, Jos
Qureshi, Nadeem
author_sort Hussein, Norita
building Nottingham Research Data Repository
collection Online Access
description Background: Globally, about five per cent of children are born with congenital or genetic disorders. The most common autosomal recessive conditions are thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease, with higher carrier rates in specific patient populations. Identifying and counselling couples at genetic risk of the conditions before pregnancy enables them to make fully informed reproductive decisions, with some of these choices not being available if genetic counselling is only offered in an antenatal setting. This is an update of a previously published review. Objectives: To assess the effectiveness of systematic preconception genetic risk assessment to improve reproductive outcomes in women and their partners who are identified as carriers of thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease in healthcare settings when compared to usual care. Search methods: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Registers. In addition, we searched for all relevant trials from 1970 (or the date at which the database was first available if after 1970) to date using electronic databases (MEDLINE, Embase, CINAHL, PsycINFO), clinical trial databases (National Institutes of Health, Clinical Trials Search portal of the World Health Organization, metaRegister of controlled clinical trials), and hand searching of key journals and conference abstract books from 1998 to date (European Journal of Human Genetics, Genetics in Medicine, Journal of Community Genetics). We also searched the reference lists of relevant articles, reviews and guidelines and also contacted subject experts in the field to request any unpublished or other published trials. Date of latest search of the registers: 20 June 2017. Date of latest search of all other sources: 16 November 2017. Selection criteria: Any randomised or quasi-randomised controlled trials (published or unpublished) comparing reproductive outcomes of systematic preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease when compared to usual care. Data collection and analysis: We identified 25 papers, describing 16 unique trials which were potentially eligible for inclusion in the review. However, after assessment, no randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease were found. Main results: No randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease were included. One ongoing trial has been identified which may potentially eligible for inclusion once completed. Authors' conclusions: As no randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis, or Tay-Sachs disease were found for inclusion in this review, the research evidence for current policy recommendations is limited to non-randomised studies. Information from well-designed, adequately powered, randomised trials is desirable in order to make more robust recommendations for practice. However, such trials must also consider the legal, ethical, and cultural barriers to implementation of preconception genetic risk assessment.
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spelling nottingham-505052019-03-14T04:30:13Z https://eprints.nottingham.ac.uk/50505/ Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease Hussein, Norita Weng, Stephen F. Kai, Joe Kleijnen, Jos Qureshi, Nadeem Background: Globally, about five per cent of children are born with congenital or genetic disorders. The most common autosomal recessive conditions are thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease, with higher carrier rates in specific patient populations. Identifying and counselling couples at genetic risk of the conditions before pregnancy enables them to make fully informed reproductive decisions, with some of these choices not being available if genetic counselling is only offered in an antenatal setting. This is an update of a previously published review. Objectives: To assess the effectiveness of systematic preconception genetic risk assessment to improve reproductive outcomes in women and their partners who are identified as carriers of thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease in healthcare settings when compared to usual care. Search methods: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Registers. In addition, we searched for all relevant trials from 1970 (or the date at which the database was first available if after 1970) to date using electronic databases (MEDLINE, Embase, CINAHL, PsycINFO), clinical trial databases (National Institutes of Health, Clinical Trials Search portal of the World Health Organization, metaRegister of controlled clinical trials), and hand searching of key journals and conference abstract books from 1998 to date (European Journal of Human Genetics, Genetics in Medicine, Journal of Community Genetics). We also searched the reference lists of relevant articles, reviews and guidelines and also contacted subject experts in the field to request any unpublished or other published trials. Date of latest search of the registers: 20 June 2017. Date of latest search of all other sources: 16 November 2017. Selection criteria: Any randomised or quasi-randomised controlled trials (published or unpublished) comparing reproductive outcomes of systematic preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease when compared to usual care. Data collection and analysis: We identified 25 papers, describing 16 unique trials which were potentially eligible for inclusion in the review. However, after assessment, no randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease were found. Main results: No randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease were included. One ongoing trial has been identified which may potentially eligible for inclusion once completed. Authors' conclusions: As no randomised controlled trials of preconception genetic risk assessment for thalassaemia, sickle cell disease, cystic fibrosis, or Tay-Sachs disease were found for inclusion in this review, the research evidence for current policy recommendations is limited to non-randomised studies. Information from well-designed, adequately powered, randomised trials is desirable in order to make more robust recommendations for practice. However, such trials must also consider the legal, ethical, and cultural barriers to implementation of preconception genetic risk assessment. Wiley 2018-03-14 Article PeerReviewed application/pdf en https://eprints.nottingham.ac.uk/50505/1/Hussein%20Coch%20Data%20Syst%20Reviews%202018.pdf Hussein, Norita, Weng, Stephen F., Kai, Joe, Kleijnen, Jos and Qureshi, Nadeem (2018) Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease. Cochrane Database of Systematic Reviews . ISSN 1469-493X Preconception; Risk assessment; Thalassaemia; Sickle cell disease; Cystic Fibrosis; Tay-Sachs disease; Review http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD010849.pub3/full doi:10.1002/14651858.CD010849.pub3 doi:10.1002/14651858.CD010849.pub3
spellingShingle Preconception; Risk assessment; Thalassaemia; Sickle cell disease; Cystic Fibrosis; Tay-Sachs disease; Review
Hussein, Norita
Weng, Stephen F.
Kai, Joe
Kleijnen, Jos
Qureshi, Nadeem
Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease
title Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease
title_full Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease
title_fullStr Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease
title_full_unstemmed Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease
title_short Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease
title_sort preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and tay-sachs disease
topic Preconception; Risk assessment; Thalassaemia; Sickle cell disease; Cystic Fibrosis; Tay-Sachs disease; Review
url https://eprints.nottingham.ac.uk/50505/
https://eprints.nottingham.ac.uk/50505/
https://eprints.nottingham.ac.uk/50505/