A framework for reporting secondary and incidental findings in prenatal sequencing: When and for whom?. (19th January 2022)

• Record Type: Journal Article
• Authors: Vears, Danya; Amor, David J.
• Other Names: Van den Veyver Igna guestEditor.
• Is Part Of: Prenatal diagnosis. Volume 42:Number 6(2022)
• Page Start: 697
• Page End: 704
• Publication Date: 2022-01-19
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.6097
• Languages: English
• ISSNs: 0197-3851

Abstract

Abstract: As the use of genomic sequencing (GS) in the prenatal setting becomes more widespread, laboratories and clinicians will be tasked with making decisions about whether to offer incidental and secondary findings to expectant parents and, if so, which ones. Unfortunately, few guidelines or position statements issued by professional bodies address the return of secondary findings specifically in the context of prenatal GS, nor do they offer clear guidance on whether, and which types of incidental findings should be reported. Laboratories and clinicians will also need to navigate other challenges, such as how to obtain sufficiently informed consent, workload burdens for both laboratories and clinicians, and funding. Here we discuss these, and other challenges associated with offering incidental and secondary findings in the context of prenatal GS. We outline existing guidelines for return of these findings, prenatally and in children. We review the existing literature on stakeholder perspectives on return of incidental and secondary findings and discuss the main practical and ethical challenges that require consideration. We then propose a framework to help guide decision‐making, suggesting a baseline routine analysis, with additional layers of analysis that could be offered, according to local laboratory policy, with additional opt‐in consent from the parents. Key points: What's already known about this topic? The use of genomic sequencing (GS) in the prenatal setting is becoming more widespread. Few guidelines or position statements from professional bodies address returning secondary findings in the context of prenatal GS. What does this review add? We summarize existing guidelines and literature on the topic. We discuss practical and ethical challenges that require consideration. We propose a framework to guide decision‐making, suggesting baseline routine analysis, with additional layers of analysis that could be offered, with opt‐in parental consent.