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Scientists are narrowing in on why some people keep avoiding Covid. BA.5 could end that luck. – NBC News

A majority of people in the U.S have had Covid-19 at least once likely more than 70% of the country, White House Covid-19 Response Coordinator Ashish Jha said on Thursday, citing data from the Centers for Disease Control and Prevention.

Many have been infected multiple times. In a study that has not been peer viewed that looked at 257,000 U.S. veterans who'd contracted Covid at least once, 12% had a reinfection by April and about 1% had been infected three times or more.

This raises an obvious question: What is keeping that shrinking minority of people from getting sick?

Disease experts are homing in on a few predictive factors beyond individual behavior, including genetics, T cell immunity and the effects of inflammatory conditions like allergies and asthma.

But even as experts learn more about the reasons people may be better equipped to avoid Covid, they caution that some of these defenses may not hold up against the latest version of omicron, BA.5, which is remarkably good at spreading and evading vaccine protection.

"It really takes two to tango," said Neville Sanjana, a bioengineer at the New York Genome Center. "If you think about having an infection and any of the bad stuff that happens after that, it really is a product of two different organisms: the virus and the human."

In 2020, New York University researchers identified a multitude of genes that could affect a person's susceptibility to the coronavirus. In particular, they found that inhibiting certain genes that code for a receptor known as ACE2, which allows the virus to enter cells, could reduce a person's likelihood of infection.

Sanjana, who conducted that research, estimated that about 100 to 500 genes could influence Covid-19 susceptibility in sites like the lungs or nasal cavity.

Genetics is "likely to be a large contributor" to protection from Covid-19, he said. "I would never say its the only contributor."

In July, researchers identified a common genetic factor that could influence the severity of a coronavirus infection. In a study of more than 3,000 people, two genetic variations decreased the expression of a gene called OAS1, which is part of the innate immune response to viral infections. That was associated with an increased risk of Covid-19 hospitalization.

Increasing the gene's expression, then, should have the opposite effect reducing the risk of severe disease though it wouldn't necessarily prevent infection altogether.

"Its very natural to get infected once you are exposed. Theres no magic bullet for that. But after you get infected, how youre going to respond to this infection, thats what is going to be affected by your genetic variants," said Ludmila Prokunina-Olsson, the study's lead researcher and chief of the Laboratory of Translational Genomics at the National Cancer Institute.

Still, Benjamin tenOever, a microbiology professor at the NYU Grossman School of Medicine who helped conduct the 2020 research, said it would be difficult for scientists to pinpoint a particular gene responsible for preventing a Covid infection.

"While there might still be certainly some genetics out there that do render people completely resistant, theyre going to be incredibly hard to find," tenOever said. "People have already been looking intensely for two years with no actual results."

Aside from this new coronavirus, SARS-CoV-2, four other coronaviruses commonly infect people, typically causing mild to moderate upper respiratory illnesses like the common cold.

A recent study suggested that repeated exposure to or occasional infections from these common cold coronaviruses may confer some protection from SARS-CoV-2.

The researchers found that T cells, a type of white blood cell that recognizes and fights invaders, seem to recognize SARS-CoV-2 based on past exposure to other coronaviruses. So when a person who has been infected with a common cold coronavirus is later exposed to SARS-CoV-2, they might not get as sick.

But that T cell memory probably can't prevent Covid entirely.

"While neutralizing antibodies are key to prevent an infection, T cells are key to terminate an infection and to modulate the severity of infection," said Alessandro Sette, the studys author and a professor at the La Jolla Institute for Immunology.

Sette said it's possible that some people's T cells clear the virus so quickly that the person never tests positive for Covid. But researchers aren't yet sure if that's what's happening.

"Its possible that, despite being negative on the test, it was a very abortive, transient infection that was not detected," Sette said.

At the very least, he said, T cells from past Covid infections or vaccines should continue to offer some protection against coronavirus variants, including BA.5.

Although asthma was considered a potential risk factor for severe Covid earlier in the pandemic, more recent research suggests that low-grade inflammation from conditions like allergies or asthma may have a protective benefit.

"Youll hear these stories about some individuals getting sick and having full-blown symptoms of Covid, and having slept beside their partner for an entire week during that period without having given it to them. People think that they must have some genetic resistance to it, [but] a big part of that could be if the partner beside them in any way has a higher than normal inflammatory response going on in their lungs," tenOever said.

A May study found that having a food allergy halved the risk of a coronavirus infection among nearly 1,400 U.S. households. Asthma didn't lower people's risk of infection in the study, but it didn't raise it, either.

One theory, according to the researchers, is that people with food allergies express fewer ACE2 receptors on the surface of their airway cells, making it harder for the virus to enter.

"Because there are fewer receptors, you will have either a much lower grade infection or just be less likely to even become infected," said Tina Hartert, a professor of medicine and pediatrics at the Vanderbilt University School of Medicine, who co-led that research.

The study took place from May 2020 to February 2021, before the omicron variant emerged. But Hartert said BA.5 likely wouldn't eliminate cross-protection from allergies.

"If something like allergic inflammation is protective, I think it would be true for all variants," Hartert said. "The degree to which it could be protective could certainly differ."

For many, the first explanation that springs to mind when thinking about Covid avoidance is one's personal level of caution. NYU's TenOever believes that individual behavior, more than genetics or T cells, is the key factor. He and his family in New York City are among those who've never had Covid, which he attributes to precautions like staying home and wearing masks.

"I dont think for a second that we have anything special in our genetics that makes us resistant," he said.

It's now common knowledge that Covid was easier to avoid before omicron, back when a small percentage of infected people were responsible for the majority of the virus's spread. A 2020 study, for example, found that 10% to 20% of infected people accounted for 80% of transmissions.

But omicron and its subvariants have made any social interaction riskier for everyone involved.

"It's probably far more of an equal playing field with the omicron variants than it ever was for the earlier variants," tenOever said.

BA.5, in particular, has increased the odds that people who've avoided Covid thus far will get sick. President Joe Biden is a prime example: He tested positive for the first time this week.

But even so, Jha said on Thursday in a news briefing, "I dont believe that every American will be infected."

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Scientists are narrowing in on why some people keep avoiding Covid. BA.5 could end that luck. - NBC News

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New Tests That Could Solve Persistent Challenges in Children’s Healthcare Presented at the 2022 AACC Annual Scientific Meeting – Yahoo Finance

CHICAGO, July 26, 2022 /PRNewswire/ -- A first-of-its-kind test could make it easier for newborns to get care for spinal muscular atrophy, a common genetic disease that is life-threatening but treatable if caught in time. Findings on this method and a second innovative test that could improve diagnosis of pediatric urinary tract infections (UTIs) will be discussed today at the 2022 AACC Annual Scientific Meeting & Clinical Lab Expo.

(PRNewsfoto/AACC)

Increasing Access to Spinal Muscular Atrophy Testing Spinal muscular atrophy is the leading inherited cause of infant death after cystic fibrosis, and early diagnosis and treatment are crucial to giving affected newborns the best chances at healthy lives. However, most newborn screening panels that use next-generation sequencing (NGS) do not detect this condition. The most common form of spinal muscular atrophy is caused by an abnormal version of the gene SMN1, which produces a protein essential to nerve cells involved in muscle movement. NGS panelswhich analyze hundreds of genes for disease-causing changestypically exclude SMN1 because of difficulty distinguishing it from another gene known as SMN2. The two differ only in a small spot.

Gustavo Barcelos Barra, PhD, and colleagues at Sabin Medicina Diagnostica in Brasilia, Brazil, developed a NGS panel that detects a mutationin that small spot on the SMN1 gene that causes spinal muscular atrophy. Using this NGS panel, they tested 52 DNA samples from spinal muscular atrophy patients, then compared the results to those from a single-gene PCR test (a widely used method for diagnosing this condition). After eliminating four samples for technical reasons, the researchers found that panel results for SMN1 and the single-gene test agreed in all cases.

Including spinal muscular atrophy on NGS panels means that "parents do not have to look for an additional test for [this condition]," said Barra. He added that his innovation would save laboratories from performing an extra test for spinal muscular atrophy along with NGS newborn screening.

Story continues

Identifying Children's UTIs QuicklyUTIs are common in children and when left untreated, they can cause acute distress, septic shock, and even kidney damage. The gold standard for diagnosing UTIs, thoughurine cultureis slow and labor-intensive for laboratory staff, leading doctors to sometimes inappropriately prescribe antibiotics before getting results. This is a serious issue that is contributing to the rise of antibiotic resistance.

A team led by Jingcai Wang, MD, PhD, of Nationwide Children's Hospital in Columbus, Ohio,is the first group of researchers to show that a faster method for diagnosing UTIs in adults could also work in children. Known as UTOPIA, this method uses urinalysis results and other variables to predict UTIs, and delivers answers well before the 2-3 days needed for culture results.

In order to evaluate this method's performance in children, the researchers used it to analyze data from the medical records of 5,353 children who previously underwent both urinalysis and urine culture for UTI. For each of these patients, the researchers entered their age, sex, risk for UTI, and urinalysis results into UTOPIA's algorithm to see how accurately it predicted their urine culture results.

Based on receiver operating curve (ROC) value, UTOPIA predicted positive urine culture results more accurately than any individual variable did on its own. The algorithm's ROC value was 0.825, versus values for individual variables, which ranged from 0.546 to 0.776. The closer the ROC value is to 1, the more accurate the testing strategy, Wang explained.

"UTOPIA is a simple way to predict urine culture results. You get quicker diagnosis of UTI and prevent potential kidney damage," Wang said. "It can potentially reduce unnecessary urine cultures, save money, and reduce use of unnecessary antibiotics in children."

Abstract InformationAACC Annual Scientific Meeting registration is free for members of the media. Reporters can register online here: https://www.xpressreg.net/register/aacc0722/media/landing.asp

Abstract A-155: Incorporating spinal muscular atrophy screening by next-generation sequencing into a comprehensive multigene panel for newborn sequencing: a pilot evaluation will be presented during:

Scientific Poster SessionTuesday, July 269:30 a.m. 5 p.m. (presenting author in attendance from 1:30 2:30 p.m.)

Abstract B-243: Evaluation of a prediction algorithm value in predicting positive urine culture in pediatrics: a retrospective cohort study at Nationwide Children's Hospital will be presented during:

Scientific Poster SessionWednesday, July 279:30 a.m. 5 p.m. (presenting author in attendance from 1:30 2:30 p.m.)

Both sessions will take place in the Poster Hall of the Clinical Lab Expo show floor at the McCormick Place Convention Center in Chicago.

About the 2022 AACC Annual Scientific Meeting & Clinical Lab ExpoThe AACC Annual Scientific Meeting offers 5 days packed with opportunities to learn about exciting science from July 24-28. Plenary sessions will explore artificial intelligence-based clinical prediction models, advances in multiplex technologies, human brain organogenesis, building trust between the public and healthcare experts, and direct mass spectrometry techniques.

At the AACC Clinical Lab Expo, more than 750 exhibitors will fill the show floor of the McCormick Place Convention Center in Chicago with displays of the latest diagnostic technology, including but not limited to COVID-19 testing, artificial intelligence, mobile health, molecular diagnostics, mass spectrometry, point-of-care, and automation.

About AACCDedicated to achieving better health through laboratory medicine, AACC brings together more than 70,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit http://www.aacc.org.

Christine DeLongAACCSenior Manager, Communications & PR(p) 202.835.8722cdelong@aacc.org

Molly PolenAACCSenior Director, Communications & PR(p) 202.420.7612(c) 703.598.0472mpolen@aacc.org

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New Tests That Could Solve Persistent Challenges in Children's Healthcare Presented at the 2022 AACC Annual Scientific Meeting - Yahoo Finance

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Purespring Therapeutics Expands Senior Team with Key Appointments – GlobeNewswire

Purespring Therapeutics Expands Senior Team with Key Appointments

Appointments include Dr Pille Harrison as VP of Clinical Development, Dr Aoife Waters as Medical Director, Nick Cetateanu as Head of Operations and Andreea Iuras as Programme Manager

London 26 July 2022 Purespring Therapeutics, a pioneering gene therapy company focused on transforming the treatment of kidney diseases, is expanding the Companys medical and operational capabilities with four senior appointments. Dr Pille Harrison joins as Vice President of Clinical Development, Dr Aoife Waters as Medical Director, Nick Cetateanu as Head of Operations and Andreea Iuras as Programme Manager.

These appointments bring decades of expertise in both gene therapy and kidney disease, which will be critical to Puresprings goal to advance its proprietary gene therapy platform to revolutionise the treatment of chronic kidney diseases.

Dr Pille Harrison is a rheumatologist with extensive experience in early and mid-stage clinical trials at small biotech. Pille joins from Alpine Immune Sciences Inc, where she was the VP of Clinical Development. Before this position she worked at Argenx and Galapagos. Pille also consulted in rheumatology at the Taunton & Somerset NHS Foundation Trust and holds a D.Phil from the University of Oxford in genetic susceptibility and severity factors in rheumatoid arthritis.

Dr Aoife Waters is a specialist in childrens kidney disease with over two decades experience in tertiary paediatric centres in Ireland, the UK and Canada and 15 years experience in nephrology. Her areas of focus include clinical and molecular aspects of glomerular disorders involving complement-mediated renal disease, haemolytic uraemic syndromes and childhood nephrotic syndromes. Academic partnerships include the Kidney Development and Disease group at UCL Great Ormond Street Institute of Child Health and Bristol Glomerular Disease Group.

Nick Cetateanu has held a variety of senior roles across cell and gene therapy including in operations, CMC, research and development, commercial launch readiness and strategy. Most recently, Nick was Senior Director at Orchard Therapeutics, before which he worked at global pharmaceutical companies BTG and Novartis.

Andreea Iuras joins from Orchard Therapeutics where she was Senior Project Manager. Prior to this, she held senior roles at gene therapy start-up Autolus as well as GSK and AstraZeneca. Her background spans program leadership, scientific research, the formulary process and product planning to drive forward multi-pipeline biopharmaceutical programs.

Richard Francis, Chief Executive Officer of Purespring, commented: Its great to be able to hire people who are so well qualified to support us in our goal of developing renal gene therapy, addressing the gap in innovation that exists in the treatments for kidney diseases for which there are limited options. These new members of the team play an important role as we build out our capabilities and we look forward to working with them.

In addition, Purespring has appointed Dimple Raval as Finance Business Partner, Kushal Paudel as Senior Scientist and Umar Ishaque as Associate Scientist, critical supporting roles that augment those senior hires.

ENDS

For further information, contact:

Purespring:

Richard Francis, CEOcontact@purespringtx.com+44 (0)20 3855 6324LinkedIn

Consilium Strategic Communications:

Amber Fennell, Jessica Hodgson, Genevieve Wilsonpurespring@consilium-comms.com

Notes to Editors

About Purespring

Purespring is the first company to treat kidney diseases by directly targeting the podocyte, a specialised kidney cell implicated in many kidney diseases, through AAV gene therapy.

Headed by former Sandoz CEO, Richard Francis, Purespring was founded on the work of Professor Moin Saleem, Professor of Paediatric Renal Medicine at the University of Bristol, where he heads a world leading group researching glomerular diseases. Purespring seeks to advance gene therapies for the treatment of both monogenic and non-monogenic chronic renal diseases that are currently poorly addressed with existing treatments.

The company also has a proprietary in-vivo pipeline engine, FunSel, which is a library of all biological factors that could be candidates for gene therapy, combined with a screening method to evaluate these factors in disease models. FunSel allows Purespring to discover new gene therapy candidates across all indications, unconstrained by genetics, to find the right candidate to make the best therapy.

An initial 45 million commitment to Purespring from Syncona Ltd is enabling Purespring to progress its assets to the clinic. Synconas Chief Investment Officer, Chris Hollowood, serves as Chairman. For more information please visit: purespringtx.com and follow us on LinkedIn.

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Purespring Therapeutics Expands Senior Team with Key Appointments - GlobeNewswire

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Gene Editing Tools Market 2022, Comprehensive Study With Top Companies and Key Players till 2030 This Is Ardee – This Is Ardee

New York(United States):-Global Gene Editing Tools Market is valued at approximately USD 407.88 million in 2021 and is anticipated to grow with a healthy growth rate of more than 18.00 % over the forecast period 2022-2028.

Genome editing (also known as gene editing) refers to a set of technologies that allow scientists to alter an organisms DNA. The bacteria then employ Cas9 or a similar enzyme to rip the viruss DNA apart, rendering it inoperable. In the lab, the CRISPR-Cas9 system operates similarly. The merger and acquisition among the companies and consistent technological advancements in the field of genome engineering tools have led to the adoption of Gene Editing Tools across the forecast period.

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For Instance: In January 2022, Pfizer, a multinational pharmaceutical and biotechnology corporation based in the U.S., signed a 4-year contract worth US$ 300 million with Massachusetts-based Beam Therapeutics, a pioneer in the development of CRISPR editing tools. In April 2021, CANbridge Pharmaceuticals, Inc., which is a renowned biopharmaceutical company, collaborated with LogicBio Therapeutics, Inc., a clinical-stage genetic medicine company. Also, with the rising awareness regarding the availability of genetically modified animals and crops and surging applications of genome engineering tools, the adoption & demand for Gene Editing Tools is likely to increase the market growth during the forecast period. However, lack of skilled professionals and high costs associated with Gene Editing Tools impede the growth of the market over the forecast period of 2022-2028.

The key regions considered for the Global Gene Editing Tools Market study include Asia Pacific, North America, Europe, Latin America and Rest of the World. North America is the leading region across the world in terms of market share owing to the presence of a robust commercial and research base for the development of advanced therapies. Whereas, Asia-Pacific is also anticipated to exhibit the highest growth rate over the forecast period 2022-2028. Factors such as government is allowing CRISPR DNA Editing of Crops to Enhance Production would create lucrative growth prospects for the Gene Editing Tools Market across Asia-Pacific region.

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Major market players included in this report are:

The objective of the study is to define market sizes of different segments & countries in recent years and to forecast the values to the coming eight years. The report is designed to incorporate both qualitative and quantitative aspects of the industry within each of the regions and countries involved in the study. Furthermore, the report also caters the detailed information about the crucial aspects such as driving factors & challenges which will define the future growth of the market. Additionally, the report shall also incorporate available opportunities in micro markets for stakeholders to invest along with the detailed analysis of competitive landscape and product offerings of key players. The detailed segments and sub-segment of the market are explained below:

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By Product:

Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR/Cas9)

Zinc Finger Nucleases (ZFNs)

Transcription Activator-Like Effector Nucleases (TALENs)

Viral Systems

Transposon Systems

Others

By Application:

Veterinary Medicine

Cell Line Engineering

Bioremediation

Food and Brewing Development

Food Waste Management

Biosensing Development

Others

By Region:

North America

U.S.

Canada

Europe

UK

Germany

France

Spain

Italy

ROE

Asia Pacific

China

India

Japan

Australia

South Korea

RoAPAC

Latin America

Brazil

Mexico

Rest of the World

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Gene Editing Tools Market 2022, Comprehensive Study With Top Companies and Key Players till 2030 This Is Ardee - This Is Ardee

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Small Interfering RNA (siRNA) Therapeutics Market Demand, Insights and Forecast Up to 2025 – BioSpace

Albany NY, United States: Small interfering RNA (siRNA) is a type of genetic medicine, which has potential to silence or knock down any over-expressed gene in a disease. It is also called short interfering RNA. These RNAs are widely used to evaluate the specific contribution of genes to a variety of cellular phenotypes including apoptosis, insulin signaling, cytokinesis, and cell differentiation. They are employed to recognize novel pathways and have a meaningful impact in validating targets for several diseases (such as AIDS, cancer, and hepatitis) and cellular processes.

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The mechanism of action of siRNA involves its introduction into a cell. The sequence of siRNA is designed in such a way that it matches with a short area of the targeted gene. Small interfering RNA is processed by a cells own enzymes to abolish mRNA of the target gene, thereby preventing the over-expression of the disease-causing gene. It is based on natural response of cells when they detect genetic abnormality or infection. It has certain advantages over different types of therapies available currently, for example, target-specificity, reduced secondary effects, and high specificity.

The pre-clinical development of small interfering RNA compound is of shorter duration (around 15 to 24 months) than that of monoclonal antibodies (around 27 to 50 months) or other traditional small molecules (around 42 to 66 months). This shortening of the pre-clinical stage is attributable to the rational design of RNAs. This design comprises mathematical algorithms assembled in software in order to select the most suitable RNA sequence to silence a specific gene target. They usually act longer than other traditional medicines.

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The small interfering RNA (siRNA) therapeutics market is expected to expand significantly during the forecast period, as only a few products are currently available in the market. For example, Britena is a product approved for skin de-pigmentation. Most of the small interfering RNA therapeutics is currently under clinical development. It would be marketed in the next few years. There exist more than 15 companies developing over 85 small interfering RNA therapies. Small interfering RNA is being studied for various disease areas.

However, most of the studies are focused on the oncology area with 27 siRNA therapies under development by major pharma companies, followed by 14 therapies for infectious diseases and eight therapies for ophthalmology. Two of the most popular methods of delivering siRNA therapies are liposome-based systems and nanoparticle-based systems.

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Liposome-based systems are associated with liver-targeted pharmacokinetics, a phenomenon that restricts the therapeutic potential of siRNA therapies to other common diseases of the liver such as hepatocellular carcinoma, hepatitis, and hypercholesterolemia.

In terms of geography, the global small interfering RNA (siRNA) therapeutics market has been segmented into North America, Latin America, Europe, Asia Pacific, and Middle East & Africa. North America dominates the market, followed by Europe. This can be attributed to the large number of ongoing clinical trials, increase in the expenditure on research and development, and availability of developed health care infrastructure in North America.

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Asia Pacific is an emerging market for siRNA therapeutics, due to the developing health care infrastructure and rising government expenditure on the health care industry in the region. On the other hand, lack of developed health care infrastructure and limited research and development activities in Middle East & Africa restrain the siRNA therapeutics market in the region.

Major players operating in the global small interfering RNA (siRNA) therapeutics market are GE Dharmacon, OPKO Health, Inc., Alnylam Pharmaceuticals, Arrowhead Research Corp, Sanofi Genzyme, Genecon Biotechnologies Co., Ltd., Arbutus Biopharma Corp, Silence Therapeutics AG, and Sylentis S.A.

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Small Interfering RNA (siRNA) Therapeutics Market Demand, Insights and Forecast Up to 2025 - BioSpace

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How the End of Roe Would Change Prenatal Care – The Atlantic

Pregnancy, in this age of modern medicine, comes with a series of routinely recommended prenatal tests: At 11 weeks, a blood draw and an ultrasound to check for conditions such as Down syndrome. At 15 weeks, another blood test, for anomalies such as spina bifida. At 18 to 22, an ultrasound anatomy scan of the babys heart, brain, lungs, bones, stomach, fingers, and toes. This is when many parents learn if theyre expecting a boy or girlbut the more pressing medical reason is to look for anatomical defects, including severe ones such as missing kidneys or missing parts of the brain and skull.

With Roe v. Wade in place in America, women undergoing prenatal tests have typically had the legal right to end a pregnancy based on the information they learn. But abortion restrictions in certain statesby gestational age or by fetal anomalyhave already started limiting that choice. And if the Supreme Court overturns Roe, as seems likely, it will be further curtailed in some states. Routine parts of prenatal care could start to look quite different in states that ban abortion than in states that allow it.

Even now, laws in more than a dozen states that restrict abortion past 20 weeks are changing the use of the second-trimester anatomy scans. People are moving those tests backward, doing them earlier than is optimal, says Laura Hercher, a genetic counselor at Sarah Lawrence College who recently conducted a survey of genetic counselors in abortion-restrictive states. But the earlier the scan, the less doctors can see. Certain brain structures, such as the cavum septum pellucidum, might not develop until week 20, says Chloe Zera, an obstetrician in Massachusetts. Being unable to find this structure could indicate a brain anomaly, or just that the scan was done too early. Doctors might also pick up evidence of a heart defect but not know how severe or fixable it is. At 20 weeks, the heart is only the size of a dime.

Read: The future of abortion in post-Roe America

Six states also currently restrict abortions on the basis of genetic anomalies. These laws typically target Down syndrome, or trisomy 21, in which the presence of a third chromosome 21 can have a range of physical and mental effects, milder in some children than others. Some states laws specifically mention Down syndrome; others extend the restrictions to a much wider range of genetic anomalies, many far more life-limiting than Down syndrome. In trisomy 13, for example, the physical anomalies are so severe that most babies live only for days or weeks. More than 90 percent do not survive past their first year.

In states that currently restrict abortion based on genetic anomalies but still allow it for other reasons under Roe, patients can get an abortion if they do not mention the genetic anomaly. This puts doctors and genetic counselors in a bind. For instance, says Leilah Zahedi, a maternal-fetal-medicine physician in Tennessee, what if doctors see a severe heart defect on an ultrasound? The underlying cause of many such heart problems is Down syndrome. But Tennessee restricts abortions specifically on the basis of trisomy 21. Should doctors tell patients about the connection to Down syndrome? Should they do the genetic testing? It could help parents prepare for everything else that comes with Down syndrome. But it would make it harder for them to get an abortion, if they chose to have one. They would need to go to a different doctor who does not know about the diagnosis, and take care not to reveal it.

Many of the current abortion restrictions do contain exemptions for cases with the most dramatic medical consequences: a fatal fetal anomaly or risk to the mothers life. If Roe is overturned, many of the trigger laws that will immediately ban abortion in some states contain such exemptions as well. But what is fatal to the baby and what risk is acceptable to the mother are not entirely clear criteria. There are very few bright lines in medicine, says Cara Heuser, a maternal-fetal-medicine physician in Utah. Laws really do not allow for all the nuance we see in medicine. They ignore the uncertainty.

When it comes to fetal anomalies, its very rare we can say, This is universally fatal, Zera told me. For example, in the case of a massive brain hemorrhage that destroys most of the brain tissue but leaves the brain stem intact, the baby can breathe at birth but will need other medical care. Does fatal mean fatal in the absence of certain medical interventions? Which ones? And does an anomaly have to be fatal immediately, or within some period after birth?

Read: When a right becomes a privilege

There is ambiguity in exceptions for the life of the mother, too. A genetic counselor in Texas told me about a recent patient whose fetus was triploid, meaning it had a complete extra set of 23 chromosomes. This is one of the universally lethal conditions. But triploidy also poses an extra risk to the mother, because these pregnancies are linked to preeclampsia, or dangerously high blood pressure. Texas currently restricts abortions past about six weeks except in medical emergencies. High blood pressure may not be an immediate medical emergency, but it can become one. Whats scary about being a person who is pregnant in Texas, says the genetic counselor, whom I agreed not to name because this person feared legal retribution in the state, is that many physicians will wait to provide treatment until moms life is truly in danger. The fetus will not survive, and delaying may only increase the risk to the mother, but we have to wait until you get sick enough to deliver you. These laws create a general climate where doctors who fear prosecution may hesitate to treat the mother. Sometimes, Heuser says, that hesitation can be fatal.

If Roe is overturned and abortion is banned in many states, testing could take on a different role in prenatal care. Zahedi told me, anecdotally, of one recent patient whose doctor told her there wasnt a point to genetic screening anymore. But she doesnt actually think abortion bans will change the use of testing, even if they will limit what patients can do afterward. Most of her patients in Tennessee already do not choose abortion, she said, but the tests can provide information that inform obstetric care and prepare parents for whats to come.

Others brought up the possibility, in the long term, of insurance companies dropping coverage for prenatal tests. Cumulatively, all of these types of screenings and tests are incredibly expensive, Hercher, of Sarah Lawrence, told me. Insurance currently has a financial incentive to cover them because preventing the birth of a child with severe medical needs saves on costs down the line. But if abortion is illegal in many states, Hercher asks, will insurance companies, especially regional ones, want to continue covering these tests? Or will patients have to pay for them out of pocket? These tests are currently routine for pregnant women, but whether they stay that way in the future could depend on where you live and what you can afford.

Read more here:
How the End of Roe Would Change Prenatal Care - The Atlantic

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