March Of Dimes Aiding Genetic Research

DANBURY — The March of Dimes Connecticut State Chapter recently awarded Danbury Hospital with a chapter community grant of $14,648 for a one-year time period to implement the Women’s Health Center Genetics Services Program. This grant will increase the availability of certified genetic counselor Deborah Starkman, MS, CGC, to see patients at the Women’s Health Center (WHC).

One of only five projects selected for funding, the grant is represents a substantial achievement for the WHC Genetics Services Program.

“We want to offer genetic counseling to as many mothers as possible,” said Ms Starkman. “We feel that it’s especially important for our underserved patients to have access to genetic counseling.”

Finding a genetic counselor locally, and having access to genetic counseling services is not as common as one may think. The National Society of Genetic Counselors (NSCG) reports a membership of only 2,125 genetic counselors worldwide.

“We are so pleased to be working with the March of Dimes in this endeavor,” said Ms Davis. “By increasing the availability of genetic counseling services to our patients, we hope to help women have happy and healthy pregnancy outcomes.”

According to the application, the WHC Genetics Services Program’s objectives and outcomes aim to increase the availability of genetic counseling services to under and uninsured women from three counseling sessions a week to a target of five to seven sessions a week. Secondly, it hopes to increase the utilization of genetic counseling services to under and uninsured women during pregnancy.

Genetic counseling will be offered to WHC patients with a family history of genetic problems; to women whose pregnancies are found in prenatal testing to be at risk for birth defects; to women who choose to have amniocentesis (for women 35 or older at delivery); to women who are undecided about having a genetic screening blood test called a quad screen; and to women with a history of low birth weight babies.

Thirdly, the project strives to offer genetic counseling advice to women preconception. Ms Starkman will conduct community and radio outreach sessions to provide information about what steps women might take to help prevent birth defects.

Ms Davis and Ms Starkman will also distribute information about the increased availability of genetic counseling by direct mailings and phone calls that will reach women through many community resources that are already in place.

Finally, by offering genetic counseling services to more under and uninsured women during pregnancy, the program hopes to demonstrate a decrease in the number of undetected birth defects and low birth weight or premature babies. Ms Starkman, along with the WHC clinical staff and Danbury Hospital perinatologists, will offer appropriate testing (quad screening, amniocentesis, targeted ultrasound) to WHC patients who are found at genetic counseling to be at higher risk for poor obstetric outcomes.

The birth outcomes of all women seen by Ms Starkman during the grant period will be monitored.

“Many women are unaware of the rapid pace of new technology in the field of genetics,” said Ms Starkman. There are many criteria for women to consider in the process of seeking genetic counseling. Following are some guidelines:

ÚIncreased maternal age (35 years or older) at delivery

ÚPrevious child with chromosome abnormality or birth defect.

* Parental chromosomal  rearrangement

ÚFamily history of genetic disease or mental retardation

ÚMultiple miscarriages or still born births

ÚConsanguinity (cousins/relatives)

ÚAbnormal testing results for blood (Down syndrome/trisomy #18; neural tube defect)

ÚAbnormal testing results from ultrasound

ÚEthnic background: African American/Caribbean (sickle cell anemia); Italian/Greek (beta thalassemia or “Mediterranean anemia”); Caucasian (cystic fibrosis); Jewish (Tay-Sachs); Asian (alpha-thalassemia)

ÚChorionic villus sampling (CVS) candidates (first trimester testing for chromosome abnormalities)

ÚAmniocentesis candidates

ÚMaternal anxiety relating to genetic issues

ÚTeratogen exposure (alcohol abuse, medication issues)

ÚPrepregnancy counseling (prevention and preparation)

Ms Starkman has worked as a genetic counselor for 26 years. She joined Danbury Hospital in 1984. She also works at the Candlewood Center for Women’s Health, where she has been employed since 1998. Her experience also includes working at the University of Connecticut Department of Genetics.

She earned a bachelor’s degree in biology from New York University, New York City, in 1972, and a master’s degree in genetic counseling in 1979 from Sarah Lawrence College in Bronxville, N.Y.

Ms Starkman became board certified in genetic counseling in 1984. She is a member of the National Society of Genetic Counselors and the American Board of Medical Genetics.

“We’re providing more complete health care,” said Ms Starkman. “It’s a matter of respect, helping patients make decisions and holding their hand through the process.”