Wednesday, September 14, 2005

Many Dads Unknowingly Raising Others' Kids

THURSDAY, Aug. 11 (HealthDayNews) -- Calling it a Pandora's Box with broad health implications, British researchers say genetic testing is informing about 4 percent of fathers that a child they are raising is not their own.
The implications are huge, the study authors noted, because such revelations often lead to divorce and increased mental health problems for both the man and woman involved, including the threat of violence by the man.
In addition, children whose lives are changed by this genetic information can struggle with low self-esteem, anxiety, and increased antisocial behavior, such as aggression.
And the problem will only grow more serious as genetic testing is used for more and more purposes, including screening for organ donations and checking for genetic-based diseases such as cancer, cystic fibrosis and heart disease, the researchers said. In addition, such testing is becoming more common in police investigations.
What's needed, the researchers said, is clearer guidance on when and how to disclose such information. They believe individual and family support services and counseling should become part of paternity-testing procedures.
"At the moment, people are often receiving the results of paternity testing through e-mail and post," said lead researcher Mark Bellis, a professor of public health at the Centre for Public Health at Liverpool John Moores University.
"People are receiving what can be pretty dramatic information without being linked into health or counseling or support services," he added. "In addition, people are coming forward in more and more numbers each year to have paternity testing done."
The report appears in the August issue of the Journal of Epidemiology and Community Health.
The authors said they based their findings on international published scientific research and conference abstracts released between 1950 and 2004.
The study found that rates of "paternal discrepancy" range on average from less than 1 percent to as high as 30 percent, depending on the group of people looked at. For women, those who are younger, poorer or have multiple sex partners are more likely to bear a child who wasn't fathered by a long-time partner, the researchers said.
An average paternal discrepancy rate of 4 percent means about one in 25 families could be affected, the researchers said.
To determine the extent of the problem, Bellis and his colleagues collected data on increasing rates of paternity testing in North America and Europe. For example, in the United States, rates more than doubled to 310,490 between 1991 and 2001, they noted.
In Great Britain, about one-third of pregnancies are unplanned, and about one in five women in long-term relationships has had an extramarital affair, the researchers reported. These are similar to figures in other developed countries, they noted.
Yet there is a lack of support services to help people who find out about a parental discrepancy from a paternity test. "Finding out a child does not belong to them [the fathers] can have effects in terms of breakup of families and issues of safety and well-being of the child and women," Bellis said.
Bellis believes that giving counseling and support to these families needs to be considered. "We need to think about how that can be delivered," he said.
He added, "In genetic testing for health conditions, in police investigations, all these can identify discrepancies in family genetics, but there is no consideration if it is a good thing or a bad thing to let the families know about those [discrepancies]."
One expert thinks the study highlights the social downside of emerging technologies.
"Not surprisingly, the disclosure of information about unsuspected paternity comes with potentially devastating effects," said Dr. David L. Katz, an associate clinical professor of public health and director of the Prevention Research Center at Yale University School of Medicine.
"But does that mean such information should be concealed when it is a byproduct of testing for other reasons? When should paternity testing be permissible, and at the request of whom?" he added.
New knowledge means new power, but not necessarily the power to use it correctly, Katz said.
"Bellis and colleagues suggest that genetic testing has provided the power to lift a lid off Pandora's Box," he said. "As they rightly point out, it will take something other than power -- namely wisdom -- to respond productively, fairly and compassionately to all that comes flying out."

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SOURCES: Mark Bellis, Ph.D., professor, public health, Centre for Public Health, Liverpool John Moores University, Liverpool, England; David L. Katz, M.D., M.P.H., associate clinical professor, public health, director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; August 2005 Journal of Epidemiology and Community Health