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Poster Session 3

Category: Genetics

Poster Session 3

(987) Optimizing Prenatal Genetic Risk Assessment: Completion Rates and Sociodemographic Factors Across Carrier Screening Modalities

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

WA

Wissam Akkary, MD

Maternal-Fetal Medicine Fellow
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States

Coauthor(s)

Lina A. Fouad, MD

Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
BS

Blair Stevens

Division of Genetics, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
MC

Meagan Choates, MS

UTHealth Houston McGovern Medical School
Houston, Texas, United States
LG

Luana Goulet, MS

Genetic Counselor
UTHealth Houston McGovern Medical School
Houston, Texas, United States
Aranza Gonzalez Cendejas, MS (she/her/hers)

Genetic counselor
UTHealth
Houston, Texas, United States
Irene A. Stafford, MD, MPH, MS

Associate Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States

Objective:
To compare completion rates of fetal risk assessment (RA) by carrier screening type (core panel, expanded carrier screening [ECS], and single-gene NIPT [sgNIPT]) and to evaluate sociodemographic predictors of RA completion. 

Study Design:
After institutional approval, we conducted a retrospective cohort study of 1,153 pregnant patients with abnormal carrier screening results between January 2023 and July 2025 at a single academic center. Completion of RA was defined as follow-up paternal testing or sgNIPT where applicable. Screening modalities included core (12%, n=142), ECS (81.6%, n=941), and sgNIPT (6.1%, n=70). Sociodemographic variables included age, parity, primary language, insurance status, and father of baby (FOB) presence at counseling visit. Multivariable logistic regression tests were used for analysis and adjusted relative risks (aRR) with 95% CI’s were reported.

Results:
RA completion occurred in 23.9% of core panel patients (34/142), 60.3% of ECS patients (568/941), and 74.3% of sgNIPT patients (52/70), p < 0.05. Among ECS patients, 69% had abnormalities that were not eligible for further testing with sgNIPT. Medicaid coverage was significantly associated with a 17% lower probability of RA completion compared to private insurance (aRR=0.83, 95% CI: 0.73–0.95). Presentation for counseling at 18–24 weeks was associated with 23% lower completion than presentation at ≤12 weeks (aRR=0.77, 95% CI: 0.61–0.94) and. FOB attendance was associated with a 40% higher likelihood of RA completion (aRR=1.40, 95% CI: 1.25–1.57). 

Conclusion:
sgNIPT was associated with the highest RA completion. However, disparities by insurance, timing of care, and partner involvement remain significant. While sgNIPT offers a promising tool to streamline genetic risk assessment, it has limitations and may not be appropriate as a standalone strategy for all patients. Thoughtful integration with equitable access and counseling strategies is warranted.