BMJ 1995;310:1199 (6 May)

Letters

Antenatal screening for cystic fibrosis

EDITOR,--Zosia H Miedzybrodzka and colleagues' claim that stepwise screening for cystic fibrosis is better than couple screening is unjustified.1 Antenatal screening for cystic fibrosis should minimise the number of women identified as being at high risk for a given proportion of affected pregnancies detected and should ensure that a diagnostic test is available for everyone defined as being at high risk. Stepwise screening fails on both counts.2 It identifies about 30 times more women as being positive on screening without increasing detection and therefore necessitates more counselling to cope with the associated anxiety. About 3% of screened women will be identified as carriers, but their partners will not have a detectable cystic fibrosis mutation. These women are told they are at risk but cannot be offered a definitive diagnostic test.

The average anxiety score in women found to be positive was slightly higher after couple screening than after stepwise screening . . . [Full text of this article]


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Relevant Article

Antenatal screening for carriers of cystic fibrosis: randomised trial of stepwise v couple screening
Zosia H Miedzybrodzka, Marion H Hall, Jill Mollison, Allan Templeton, Ian T Russell, John C S Dean, Kevin F Kelly, Theresa M Marteau, and Neva E Haites
BMJ 1995 310: 353-357. [Abstract] [Full Text]

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