Factors influencing genetic counseling attendance rate: a geographically based study

A study of factors influencing genetic counseling attendance rate has been conducted in the Bouches-du-Rhône area, in the south of France. In this area, a birth defects monitoring system (Eurocat n. 22) annually covers 23,000 births. All the genetic services are delivered by only one genetic center located in Marseilles, and the data collected are computerized. The comparison of these two data bases gives an opportunity to estimate the rate of genetic counseling attendance after the occurrence of an affected stillbirth or live birth. Among the parents of 358 infants born in 1983-84 in this area with a pathology requiring genetic counseling, 226 (63 per cent) attended the Genetic Center within the first year after birth. The rate of attendance is statistically higher (p less than 0.01) for the parents who had a stillbirth (78 per cent) than for those who had a live birth (57 per cent). It is also higher (p less than 0.01) for the Marseilles maternities group (68 per cent) than for the group outside Marseilles (50 per cent). The referral delays are also analyzed according to malformation etiology and to viability of the child by the eighth day of life. Besides evaluating a particular genetic center's effectiveness in diffusing information to the public concerned, this work shows that couples' request is strongly dependent on a psychological need.