Will babies with Down syndrome disappear?
Pregnant women have access to more prenatal tests than ever before with numerous options available to determine the likelihood of genetic disorders. What if those tests slowly led to fewer babies being born with Down syndrome and if the disorder eventually disappeared?
Well, it's happening, according to new research.
Between 1989 and 2005 there was a 15 percent decrease in births of babies with Down syndrome, according to new study by Dr. Brian Skotko, a genetics fellow at Children's Hospital Boston.
It's a striking finding, considering that more women are waiting longer to have children -- a factor that increases the chance of Down syndrome. If there were no prenatal testing, researchers would have expected the opposite - a 34 percent increase, not a decrease, Skotko found. Instead, women are finding out the diagnosis of Down syndrome and choosing not to continue the pregnancy.
The research, appearing in the latest issue of the journal Archives of Disease in Childhood, raises some interesting questions about how doctors and patients should navigate such a diagnosis. As it is now, doctors do a poor job explaining Down syndrome and discussing the diagnosis with soon-to-be parents, Skotko says. This could only get tougher in the future.
New prenatal testing -- available within a year or so -- could allow doctors to detect genetic abnormalities earlier in a woman's pregnancy and with a simple blood test. That could lead to more women choosing not to continue with their pregnancies if their baby tests positive for Down syndrome, complicating matters for doctors and patients, the author states.
Unless improvements are made prior to the arrival of new prenatal tests, a true collision is on its way, Skotko says. More women will be going through the testing process, which could lead to a lot of difficult, uncomfortable conversations between physicians and expectant parents.
Doctors need better guidelines on how to deliver a Down syndrome diagnosis and should limit injecting their personal viewpoints into a patient's decision whether to carry on with the pregnancy, he says.
Skotko also asks a provocative question: does genetic testing go too far?
Where should our professional organizations draw the line? Should expectant parents be able to select out fetuses with an undesired sex? Should fetuses with genes that predispose them to adult breast cancer be prenatally identified? Should couples in the future be supported if they wish to terminate fetuses with genes correlated with sexual preferences? The age is swiftly coming where not all possible technologic advances may bring welcomed change.
photo courtesy of stock.xchng
Comments
What a sloppily written post. The author asks the question "Will babies with Down Syndrome disappear?" and then suggests it is happening. No it's not! It is reasonable to expect a reduction in Down Syndrome live births as women abort when faced with a Down Syndrome diagnosis early in their pregnancy. But disappearance of Down Syndrome can only occur if all women with such a diagnosis choose to abort. Clearly that will not happen, since there is still a healthy percentage of women who categorically object to abortion.
I am also puzzled by the author's "ethical dilemma" posed at the end of the article. In a country that allows women to abort children for no reason at all, why should the medical establishment care what genetic information goes into a woman's decision? What a bizarre twist! Are those who take the position that it is just a fetus and a woman's choice somehow going to have a problem if a woman makes that decision on the basis of gender or sexual preference? They don't have a leg to stand on!
Posted by: Greg DiDio | September 26, 2009 3:19 PM