Paternity testing using DNA
- Louise Wilkins-Haug, MD, PhD
Louise Wilkins-Haug, MD, PhD
- Section Editor — Prenatal Diagnosis and Genetics
- Professor of Obstetrics, Gynecology, and Reproductive Biology
- Harvard Medical School
- Vanessa A Barss, MD, FACOG
Vanessa A Barss, MD, FACOG
- Senior Deputy Editor — UpToDate
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Associate Clinical Professor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
Historically, the primary objective of paternity testing was to determine whether a man accused of paternity (ie, alleged father) could be accurately excluded as the biological father of a given child. Testing was performed using systems involving red cell antigens, serum proteins, red cell enzymes, and human leukocyte antigen. Actual proof of paternity is not possible with any laboratory test because there is always a chance that another man could have the same test results as the alleged father since the number of markers tested is limited. However, advances in DNA technology have made it possible for paternity testing to produce highly conclusive evidence of paternity or absence of paternity.
Clinicians should have some knowledge of paternity testing because they may face situations where they will need to understand the process, results, accuracy, limitations, and implications of these tests. For example, court-ordered paternity testing is becoming more common. In addition, patients may ask for these tests or for help with interpretation of test results since paternity testing is now directly available to the general public.
Paternity testing may be ordered by a court or initiated by individuals for personal reasons. Reasons for testing include issues relating to:
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- Postnatal sources of test samples
- Prenatal sources of test samples
- Step one: Determine markers shared by mother and child
- Step two: Determine the paternity index
- Step three: Determine the combined paternity index
- LEGAL STANDARD FOR PATERNITY
- SPECIAL SITUATIONS
- Alleged fathers who are brothers
- - Monozygotic twins
- Alleged father not available
- - Grandparent testing
- - Family reconstruction test
- Sample case
- - Sibling test
- - Y-STR DNA test
- Maternal sample is not available
- INADVERTENT DISCOVERY OF FALSE PATERNITY
- FINDING AN ACCREDITED TESTING FACILITY
- ETHICAL CONSIDERATIONS
- Standards and guidelines
- SUMMARY AND RECOMMENDATIONS