Welcome to Chinese Journal of Evidence-Based Pediatrics,Today is
中文版

Chinese Journal of Evidence -Based Pediatric ›› 2015, Vol. 10 ›› Issue (6): 405-408.

• Original Papers • Previous Articles     Next Articles

A retrospective analysis to identify the factors influencing parental pregnancy decisions in pregnancies with fetal cardiac anomalies

WU Lin1,5, SUN Qi2,5, YANG Hao-sheng3, YAN Wei-li4, ZHAO Lu1, SUN Lu-ming2   

  1. 1 Cardiovascular center, Children's Hospital of Fudan University, Shanghai 20102, China; 2 Fetal medicine unit, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200040, China; 3 Weiyu High School, Shanghai 200231, China; 4 Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai 201102, China; 5 Contribute equally to this work
  • Received:2015-12-24 Revised:2015-12-24 Online:2015-12-05 Published:2015-12-04
  • Contact: SUN Lu-ming

PDF

1409

Abstract:

Objective The aim of the study was to identify the factors influencing parental pregnancy decisions after a prenatal diagnosis of cardiac anomalies in Chinese population in the setting of tertiary level diagnosis and consultation. The study may be helpful to estimate the future prevalence of live birth congenital heart disease. Methods A total of 162 fetuses prenatally diagnosed with cardiac anomalies in our institute were retrospectively analyzed from January 2011 to December 2014. Each family was provided with detailed consultation for the diagnosis, severity, treatment options and long-term prognosis of the anomaly with a multidisciplinary approach. Data with respect to the general maternal and fetal characteristics and pregnancy outcome were collected for all cases, and multivariable logistic regression analysis was performed to determine which factors influenced the parents' pregnancy decisions. Results Of the 162 cases, the mean gestational age at diagnosis was 26.5 weeks (ranging from 17.4 to 39.5 weeks), and 24 fetuses (14.8%) were associated with major extra-cardiac malformations. Overall, 67 (41.4%) pregnancies were interrupted, while the rates of termination in mild, moderate and severe groups of fetuses classified by severity of cardiac anomalies were 16.0%, 51.1% and 76.2%, respectively, and that of fetuses associated with major extra-cardiac anomalies reached 79.2%. Multivariable logistic regression analysis identified that severity of cardiac anomalies (OR=9.001, 95％CI: 4.143-19.557,P<0.001), presence of extra-cardiac anomalies (OR=3.801, 95%CI: 1.814-7.962, P<0.001) and gestational age at diagnosis (OR=0.750, 95%CI: 0.653-0.861, P<0.001) were three major factors contributing to the probability of pregnancy termination. Conclusion In China, the termination of pregnancy following prenatal diagnosis of cardiac anomalies is more frequent than that in the developed countries, mainly due to no restriction of gestational age for termination. The parents are more likely to adopt for termination in the cases of more complex cardiac anomalies or in association with major extra-cardiac malformations.