ANTENATAL SCREENING FOR CYSTIC-FIBROSIS - A TRIAL OF THE COUPLE MODEL

Objective-To assess the delivery and acceptability of antenatal couple screening for cystic fibrosis. Carrier status was notified only when both members of a partnership had cystic fibrosis alleles and therefor e a one in four risk of having an affected child. Design-Mouthwash sam ples were tested when both partners participated. Results were returne d only to positive couples. Setting-Two large maternity hospitals in E dinburgh. Subjects-Screening was offered to all couples who booked at one of the two hospitals. Main outcome measures-(a) The take up of scr eening, carriers and carrier couples identified, take up of prenatal d iagnosis, and numbers of affected fetuses detected; (b) questionnaire measures of patient satisfaction and stress. Results-Screening was off ered to 8536 couples. 714 (8.4%) were regarded as ineligible, usually because of late booking or absence of a partner. 1900 (24.3%) of the r emainder declined screening. Among the 5922 screened couples, four tes ted positive-that is, both partners were cystic fibrosis heterozygotes . Ah four elected to have prenatal diagnosis. There were three termina tions of pregnancy because of an affected fetus, one couple having two successive pregnancies with affected fetuses. The participation rate was 76% for eligible couples (5922/7822) and 69% for all couples (5922 /8536). Only 89 screened couples (1.5%) requested information on indiv idual carrier status. No anxiety was detected among a cohort of the sc reened population, and 99% of questioned participants expressed satisf action with the concept of couple screening. Conclusions-Antenatal cou ple screening is a satisfactory and acceptable way of screening for cy stic fibrosis and has been adopted as routine in the two trial hospita ls.