Readiness for Prenatal Genomic Medicine: A Cross-Sectional Survey of Obstetricians' Competence and Attitudes Toward Whole-Exome Sequencing in Xinjiang, China.

Introduction: As prenatal whole-exome sequencing (WES) becomes increasingly available, general obstetricians need to identify appropriate candidates for referral, while maternal-fetal medicine (MFM) specialists are involved in WES-related counseling, testing decisions, and pregnancy management. This study assessed obstetricians' self-reported competence and attitudes toward prenatal WES and explored MFM specialists' perspectives in Xinjiang, a geographically vast and resource-limited region in northwestern China. Methods: A two-stage cross-sectional survey was conducted between April 2025 and February 2026 using self-administered questionnaires. In the first-stage survey, 849 questionnaires were collected from obstetricians providing antenatal care across Xinjiang, of which 666 were valid and included. The second-stage survey was completed by 36 of 71 eligible MFM specialists. The surveys evaluated self-perceived competence, attitudes toward WES indications, and MFM specialists' perspectives on testing strategies, timing, and result disclosure. Group comparisons used non-parametric tests, and multivariable binary logistic regression identified factors associated with self-reported competence. Results: Among 666 obstetricians, self-perceived competence was lowest for WES and single-gene disorders across different technologies and genetic disorders, respectively. MFM specialization was the factor most consistently associated with higher self-reported competence (OR range: 3.07-6.36; all Conclusion: Obstetricians in Xinjiang showed favorable attitudes toward prenatal WES but limited self-perceived competence in counseling and interpretation. These findings highlight a gap between the expanding use of genomic testing and clinicians' perceived preparedness, emphasizing the need for targeted education and clearer clinical guidance.