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Genomics for Health in Preconception and Prenatal Periods

Authors

  • Siobhan Dolan,

    1. Siobhan Dolan, MD, MPH, Assistant Professor, Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY; Janis Biermann, MS, Executive Vice-President, Education and Health Promotion, March of Dimes Birth Defects Foundation, White Plains, NY; Karla Damus, RN, MSPH, PhD, Associate Professor, Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY. The authors thank Dr. Jean Jenkins for her thoughtful contributions. Correspondence to Dr. Dolan, Obstetrics & Gynecology and Women's Health Albert Einstein College of Medicine, Montefiore Medical Center, Belfer 501, 1300 Morris Park Avenue, Bronx, NY 10461. E-mail: siobhanmdolan@yahoo.com
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  • Janis Biermann,

    1. Siobhan Dolan, MD, MPH, Assistant Professor, Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY; Janis Biermann, MS, Executive Vice-President, Education and Health Promotion, March of Dimes Birth Defects Foundation, White Plains, NY; Karla Damus, RN, MSPH, PhD, Associate Professor, Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY. The authors thank Dr. Jean Jenkins for her thoughtful contributions. Correspondence to Dr. Dolan, Obstetrics & Gynecology and Women's Health Albert Einstein College of Medicine, Montefiore Medical Center, Belfer 501, 1300 Morris Park Avenue, Bronx, NY 10461. E-mail: siobhanmdolan@yahoo.com
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  • Karla Damus

    1. Siobhan Dolan, MD, MPH, Assistant Professor, Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY; Janis Biermann, MS, Executive Vice-President, Education and Health Promotion, March of Dimes Birth Defects Foundation, White Plains, NY; Karla Damus, RN, MSPH, PhD, Associate Professor, Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY. The authors thank Dr. Jean Jenkins for her thoughtful contributions. Correspondence to Dr. Dolan, Obstetrics & Gynecology and Women's Health Albert Einstein College of Medicine, Montefiore Medical Center, Belfer 501, 1300 Morris Park Avenue, Bronx, NY 10461. E-mail: siobhanmdolan@yahoo.com
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Abstract

Purpose: To review and report changes in genomic-based knowledge and care during the preconception and prenatal periods.

Design: Integrative review of relevant medical and nursing literature.

Findings: Client education and counseling are needed to understand genomic information and provide guidance in interpreting this information and making decisions. The factors that influence decision-making about testing and acting on test results constitute a complex process that has not been well studied. Family history is an important tool for obtaining genomic information and can assist women and families in understanding risk preconceptionally and prenatally. Genomic research has enhanced understanding of the mechanisms of birth defects such as neural tube defect and will likely provide research opportunities to better understand complex perinatal outcomes such as preterm birth.

Conclusions: Research, education, advocacy, and anticipatory guidance are needed as women and families obtain more genetic and genomic information before and during pregnancy. All nurses will be involved in helping patients use genetic and genomic information to understand risk and to develop strategies to modify risk, and in translating the expanding array of genomic information to improve birth outcomes.

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