Reproductive Behaviour of Couples at Risk for Sickle Cell Disease in Cuba: a Follow‐Up Study

Three hundred and forty-three Cuban women at risk of having children with sickle cell anaemia or sickle cell-haemoglobin C disease were interviewed 2–8 years after the index pregnancy (that in which their risk was detected). The aim was to collect information on their attitude towards prenatal diagnosis in subsequent pregnancies. Twenty-two per cent (75/343) had dissolved their marriage and 9 per cent of these (7/75) considered that their at-risk status had influenced the separation. Sixty-three per cent of stable couples at risk (168/268) had decided to have no further children; 27 per cent of these (45/168) were afraid of having an affected child and 4 per cent (7/168) were afraid of the obstetric procedure. Nineteen per cent of the stable couples at risk (52/268) had had at least one further child or pregnancy. Of these, 44 per cent (23/52) requested prenatal diagnosis early and spontaneously, and a further 44 per cent (23/52) requested prenatal diagnosis but after re-identification by screening and recounselling. Only 12 per cent (6/52) did not request prenatal diagnosis. Attitude towards prenatal diagnosis was most positive among more educated women. The general perception of the prevention programme was good. © John Wiley & Sons, Ltd.