Communicating Risk in Prenatal Genetic Testing


  • Elena A. Gates MD

    Corresponding authorSearch for more papers by this author
    • Elena A. Gates, MD, is Professor of Clinical Obstetrics, Gynecology, and Reproductive Sciences and Director of the Division of General Gynecology at the University of California, San Francisco. She has been involved nationally in projects aimed at enhancing patient decision making about prenatal genetic testing.

University of California, San Francisco, 2356 Sutter Street, 3rd Floor, San Francisco, CA 94115. E-mail:


Prenatal testing for Down syndrome and neural tube defects has become routine, and testing for other genetic conditions is becoming commonplace. Counseling about these tests involves a discussion of risk information, so pregnant women and their partners can use the information effectively when they make choices about testing. Discussing risk can be challenging, as many individuals, particularly those of lower literacy, have a poor understanding of the numerical concept of risk. Furthermore, whether risk is comprehended accurately or not, it is interpreted by patients in light of their existing knowledge and past experiences. Strategies available to optimize understanding of risk include communication of risk figures as frequencies rather than as probabilities or percentages and explicit discussion of a woman's preconceptions about her risk and about the condition being tested for.