LAUSR

Key Points Question Are site of care, clinician, and patient-specific factors associated with differences in whether reproductive genetic carrier screening was ordered prior to vs during pregnancy across a health care system? Findings This cross-sectional study of 6509 patients who completed carrier screening ordered across the Mass General Brigham integrated health care system in Boston, Massachusetts, including 4 hospitals, 32 clinical sites, and 161 ordering clinicians, from October 1, 2018, through September 30, 2019, found that most (63%) had prenatal screening. Clinician specialty was associated with the greatest variation in timing among observed characteristics. Meaning These findings suggest that engaging clinicians who see patients prior to pregnancy may improve access to preconception carrier screening.