Knowledge, Attitude, and Cultural Beliefs toward Genetic Counselling among Antenatal Women: A Systematic Review

Genetic counselling, a subspecialty of medicine that aims to provide information and assistance to individuals and families who are at risk for a genetic disorder. It facilitates a woman to understand hereditary diseases, genetic risk factors, antenatal screening options and reproductive options during antenatal care. Genetic counselling has become more relevant for more responsible reproductive decision making, with the advance of prenatal diagnostic techniques. In several developing environments however, a lack of knowledge, misconceptions, family pressure and the lack of genetic services limits access to genetic counselling. Objectives The aim was to review and summarise existing literature on the knowledge, attitude and cultural beliefs of pregnant women with regard to genetic counselling to make an assessment of the effectiveness of education on awareness and acceptance of genetic counselling. Materials and Methods PubMed, Scopus, Google Scholar, Web of Science and ScienceDirect were searched systematically. Several studies were retrieved and then screened for eligibility to analysis, as per the predetermined screening criteria, which included women undergoing ANC and outcome studies of awareness, attitude, cultural perception, acceptance and educational interventions. Information regarding genetic disorders, before the prenatal genetic test, cultural beliefs, acceptance of genetic services, and outcomes after the genetic test were pooled together and described using pooled descriptive estimates, weighted mean prevalence, and consistency index. Results There was a low level of awareness of genetic counselling in the women attending antenatal clinics. The pooled percentage was 36.5% to have sufficient knowledge about prenatal genetic screening and 63.5% lacked the knowledge. 3% of respondents knew about invasive prenatal testing (IPT) and 7% knew about non-invasive prenatal testing (NIPT). Despite these shortcomings, the majority felt positive about the role of a genetic counsellor (87.1%) and thought prenatal genetic testing is beneficial and acceptable (more than 94%). The majority would accept a service (97.1% wanted to seek out genetic counselling if offered). All educational interventions showed a consistent rise in knowledge about the various genetic disorders, awareness of reproductive screening tests, and confidence in reproductive decision-making and acceptance of genetic counselling services. Conclusions There is a low uptake of the genetic services at study as well as a low level of knowledge about genetic counselling despite positive attitudes of the women attending the antenatal clinic. Structured educational interventions are effective in enhancing the knowledge, understanding and informed choice of learners. Routine information and structured genetic counselling during antenatal classes could help increase rates of service uptake and lead to improved maternal and fetal health.