The influence of genetic counselors on the acceptance of mid-trimester amniocentesis

Objective. To determine the effect of the genetic counselor on the acceptance of genetic amniocentesis. Methods. We studied women with singleton pregnancies who would be at least 35 years of age at the estimated date of delivery without fetal structural anomalies or family history of chromosomal abnormalities. The acceptance rate of genetic amniocentesis among women evaluated by each counselor was compared with the average acceptance rate for our population. Chi-square test, Fisher exact test and ANOVA were used for analysis. Results. Of the 2,180 women met our inclusion criteria, 1,719 (78.9%) accepted genetic amniocentesis. The maternal age at estimated date of delivery, the proportion of women who conceived by in vitro fertilization, and the proportion with history of miscarriage were similar among women evaluated by each of the six genetic counselors. However, the acceptance rate of genetic amniocentesis was significantly lower in women evaluated by counselor C [115/170 (67.6%), P = 0.001] and significantly higher in the group evaluated by counselor D [138/154 (89.6%), P = 0.002] compared with the overall study population rate [1719/2180 (78.9%)]. The acceptance rate of 80.4% (210/261, P = 0.52), 75.6 % (232/307, P = 0.23), 80.9% (443/547, P = 0.30] and 78.4% (581/741, P = 0.83) for Counselors A, B, E and F respectively did not differ from the overall study population rate. Conclusions. Considerable variation exists in the acceptance rate of genetic amniocentesis among women based on the genetic counselor.