UK Minister warns of inbreeding in British Pakistanis

[panamania79 2]

when we got married they asked us if we were related

eta: while getting the marriage certificate the girl said "y'all ain't related are ya?"

Was that in West Virginia ?

[britty 1]

Mags,

This is clearly your bag so I was wondering if you could answer a question. For those of us interested in possibly starting a family later in life, are there statistics to show the increase in risks in a woman becoming pregnant at say 36 versus 39 ?? I know its a relatively short time span, and probably irrelevant in a woman in her early 20's, but it could be significant later in life ?

ta !

[garya505 2]

Mags,

This is clearly your bag so I was wondering if you could answer a question. For those of us interested in possibly starting a family later in life, are there statistics to show the increase in risks in a woman becoming pregnant at say 36 versus 39 ?? I know its a relatively short time span, and probably irrelevant in a woman in her early 20's, but it could be significant later in life ?

ta !

Sorry Mags, I'll jump in here cause I happen to have have this one handy for Downs Syndrome:

33 0.17%

36 0.35%

39 0.72%

42 1.49%

45 3.13%

48 6.25%

[Hilarious Clinton 452]

This problem will work itself out on it's own. Just give it time.

[Mags 112]

Mags,

This is clearly your bag so I was wondering if you could answer a question. For those of us interested in possibly starting a family later in life, are there statistics to show the increase in risks in a woman becoming pregnant at say 36 versus 39 ?? I know its a relatively short time span, and probably irrelevant in a woman in her early 20's, but it could be significant later in life ?

ta !

Gary has quoted some statistics which is great. I will just add these ones as they give you another way of looking at it:

32 1/725

33 1/592

34 1/465

35 1/365

36 1/287

37 1/255

38 1/177

39 1/139

40 1/109

41 1/85

42 1/67

43 1/53

44 1/41

45 1/32

46 1/25

47 1/20

48 1/16

49 1/12

So, yes there is a risk the older you get and, as you can see, the older you are the higher the risk. In the Fetal Medicine Unit that I was working in we offered something called a Nuchal Screen during the 11-13 week scan. This measures the nuchal fold on the back of the fetus' neck. In the case of a fetus that may have Down Syndrome (or another syndrome, like Turner Syndrome, Kleinfelters, or another Trisomy) the Nuchal fold will be increased, often to a very large size.

A Nuchal fold measurement of 1-2.5mm is fine (in most cases, there are exceptions of course) but should the fold measure larger than 2.5mm then prenatal invasive testing should be offered. At that point we would then also take the Nuchal fold measurement, add the woman's age, note any abnormalities on the scan and get a new risk assessment; in some cases this would indicate a 1:2 chance. However, I'm not sure if this test is done in many places in the USA due to the special equipment and training that is needed to perform it and I know that it wasn't routinely offered in many parts of the UK either (I know a woman from Reading who had to pay extra to have a Nuchal screening done).

If you lived in central London it was offered routinely, mainly due to to Kypros Nicolaides and his pioneering work. The director of the Fetal Medicine Unit I worked at trained with him and thusly started bringing in the Nuchal fold test routinely too. All of the major hospitals in London were offering it by the time I left in November 2006. If this test is undertaken the staff must be certified by the Fetal Medicine Foundation in London as it is they who set the international standards and provide the software that enables a doctor to evaluate your risk factors. This includes all places offering it in the USA, Canada, France, Germany etc - they all have to answer to London's FMF.

Edit: Just want to add that the Nuchal fold is only visible on a scan during the 11-14 week gestational period.

Edited February 12, 2008 by Mags

[britty 1]

Mags,

This is clearly your bag so I was wondering if you could answer a question. For those of us interested in possibly starting a family later in life, are there statistics to show the increase in risks in a woman becoming pregnant at say 36 versus 39 ?? I know its a relatively short time span, and probably irrelevant in a woman in her early 20's, but it could be significant later in life ?

ta !

Gary has quoted some statistics which is great. I will just add these ones as they give you another way of looking at it:

32 1/725

33 1/592

34 1/465

35 1/365

36 1/287

37 1/255

38 1/177

39 1/139

40 1/109

41 1/85

42 1/67

43 1/53

44 1/41

45 1/32

46 1/25

47 1/20

48 1/16

49 1/12

So, yes there is a risk the older you get and, as you can see, the older you are the higher the risk. In the Fetal Medicine Unit that I was working in we offered something called a Nuchal Screen during the 11-13 week scan. This measures the nuchal fold on the back of the fetus' neck. In the case of a fetus that may have Down Syndrome (or another syndrome, like Turner Syndrome, Kleinfelters, or another Trisomy) the Nuchal fold will be increased, often to a very large size.

A Nuchal fold measurement of 1-2.5mm is fine (in most cases, there are exceptions of course) but should the fold measure larger than 2.5mm then prenatal invasive testing should be offered. At that point we would then also take the Nuchal fold measurement, add the woman's age, note any abnormalities on the scan and get a new risk assessment; in some cases this would indicate a 1:2 chance. However, I'm not sure if this test is done in many places in the USA due to the special equipment and training that is needed to perform it and I know that it wasn't routinely offered in many parts of the UK either (I know a woman from Reading who had to pay extra to have a Nuchal screening done).

If you lived in central London it was offered routinely, mainly due to to Kypros Nicolaides and his pioneering work. The director of the Fetal Medicine Unit I worked at trained with him and thusly started bringing in the Nuchal fold test routinely too. All of the major hospitals in London were offering it by the time I left in November 2006. If this test is undertaken the staff must be certified by the Fetal Medicine Foundation in London as it is they who set the international standards and provide the software that enables a doctor to evaluate your risk factors. This includes all places offering it in the USA, Canada, France, Germany etc - they all have to answer to London's FMF.

Edit: Just want to add that the Nuchal fold is only visible on a scan during the 11-14 week gestational period.

Thank you - very informative reading. I wasn't even aware of Nuchal screening so very grateful for the info. Thanks to Gary too.

[mawilson 2,133]

Edit: Just want to add that the Nuchal fold is only visible on a scan during the 11-14 week gestational period.

So the idea is that you can still abort the baby if you find a dodgy Nuchal fold?

[garya505 2]

Edit: Just want to add that the Nuchal fold is only visible on a scan during the 11-14 week gestational period.

So the idea is that you can still abort the baby if you find a dodgy Nuchal fold?

This is why we opted out of the AFP screening. The only real reason I can see for AFP is to detect defects so you can abort. Since both my wife and I are pro-life, this would not be an option. Since there are a lot of false positives to AFP tests, we could have a lot of needless worry and we couldn't do anything about anything they thought they detected anyway.

[Mags 112]

Edit: Just want to add that the Nuchal fold is only visible on a scan during the 11-14 week gestational period.

So the idea is that you can still abort the baby if you find a dodgy Nuchal fold?

There are two types of prenatal invasive testing. The CVS (chorionic villus sampling) can be done as early as 11 weeks, this takes out villi from the placenta through a needle in the mother's stomach. As the baby and placenta are grown from the same genetic material you can karyotype the placenta and get a pretty accurate diagnosis of the fetal karyotype (i.e. 46,XY/XX for a normal baby or 47,XY/XX+21 for Down Syndrome). The amniocentesis isn't recommended before 16 weeks as there aren't enough discarded cells in the amniotic fluid to accurately determine the fetal karyotype. Average gestational age for an amniocentesis is 18 weeks, ideally.

In the UK, if you are under 14 weeks' gestation and there is something wrong with the baby you can have a suction termination. This means that the mother doesn't have to go through a full labour. So, yes, if you have a CVS done at 12 weeks and your baby is affected with a genetic syndrome AND you don't wish to continue with the pregnancy then it is an easier surgical procedure and less emotionally daunting for the mother too.

Edit: Just want to add that the Nuchal fold is only visible on a scan during the 11-14 week gestational period.

So the idea is that you can still abort the baby if you find a dodgy Nuchal fold?

This is why we opted out of the AFP screening. The only real reason I can see for AFP is to detect defects so you can abort. Since both my wife and I are pro-life, this would not be an option. Since there are a lot of false positives to AFP tests, we could have a lot of needless worry and we couldn't do anything about anything they thought they detected anyway.

AFP is not part of the pre-natal screening programme in the UK. In fact, AFP is no longer used in most places as it is thought of to be an antiquated method of determining fetal abnormalities. CVS and AF invasive testing is much more reliable and quicker in the majority of cases.

[Amby 490]

hey mags do you know how often to people actually choose to abort if there is an abnormality?

[Alex+R 0]

Edit: Just want to add that the Nuchal fold is only visible on a scan during the 11-14 week gestational period.

So the idea is that you can still abort the baby if you find a dodgy Nuchal fold?

There are two types of prenatal invasive testing. The CVS (chorionic villus sampling) can be done as early as 11 weeks, this takes out villi from the placenta through a needle in the mother's stomach. As the baby and placenta are grown from the same genetic material you can karyotype the placenta and get a pretty accurate diagnosis of the fetal karyotype (i.e. 46,XY/XX for a normal baby or 47,XY/XX+21 for Down Syndrome). The amniocentesis isn't recommended before 16 weeks as there aren't enough discarded cells in the amniotic fluid to accurately determine the fetal karyotype. Average gestational age for an amniocentesis is 18 weeks, ideally.

In the UK, if you are under 14 weeks' gestation and there is something wrong with the baby you can have a suction termination. This means that the mother doesn't have to go through a full labour. So, yes, if you have a CVS done at 12 weeks and your baby is affected with a genetic syndrome AND you don't wish to continue with the pregnancy then it is an easier surgical procedure and less emotionally daunting for the mother too.

Edit: Just want to add that the Nuchal fold is only visible on a scan during the 11-14 week gestational period.

So the idea is that you can still abort the baby if you find a dodgy Nuchal fold?

This is why we opted out of the AFP screening. The only real reason I can see for AFP is to detect defects so you can abort. Since both my wife and I are pro-life, this would not be an option. Since there are a lot of false positives to AFP tests, we could have a lot of needless worry and we couldn't do anything about anything they thought they detected anyway.

AFP is not part of the pre-natal screening programme in the UK. In fact, AFP is no longer used in most places as it is thought of to be an antiquated method of determining fetal abnormalities. CVS and AF invasive testing is much more reliable and quicker in the majority of cases.

Oo I didn't know that. So if you get an amnio, it's usually at the point where you can't have a suction abortion anymore?

[mawilson 2,133]

hey mags do you know how often to people actually choose to abort if there is an abnormality?

More importantly, why would anyone choose not to?

[Amby 490]

hey mags do you know how often to people actually choose to abort if there is an abnormality?

More importantly, why would anyone choose not to?

well that was kinda my question but I wanted to word it differently so to not be attacked by pro-lifers

[mawilson 2,133]

hey mags do you know how often to people actually choose to abort if there is an abnormality?

More importantly, why would anyone choose not to?

well that was kinda my question but I wanted to word it differently so to not be attacked by pro-lifers

You're so clever

[garya505 2]

What are the risks with amnio? Any percentages?