PDF(Pubmed)
Abstract：
The prenatal diagnosis of fetal heart disease potentially influences parental decision-making regarding pregnancy termination. Existing literature indicates that the severity, whether in complexity or lethality, significantly influences parental decisions concerning abortion. However, questions remain as to how fetal heart disease severity impacts parental decisions, given recent advancements in postsurgical outcomes. Therefore, we investigated risk factors associated with parents\' decision-making regarding abortion following a prenatal diagnosis of fetal heart disease. Our analysis included 73 (terminated: n = 37; continued: n = 36) pregnancies with a fetal heart disease diagnosed before 22 weeks of gestation. Increased gestational age at diagnosis reduced the likelihood of parents\' decision on termination (Model 1: adjusted odds ratio, 0.94; 95% confidence interval 0.89-0.99; Model 2: 0.95 0.90-0.997). Critical disease (5.25; 1.09-25.19) and concurrent extracardiac or genetic abnormalities (Model 1: 4.19, 1.21-14.53; Model 2: 5.47, 1.50-19.96) increased the likelihood of choosing abortion. Notably, complex disease did not significantly influence parental decisions (0.56; 0.14-2.20). These results suggest that parental decision-making regarding abortion may be influenced by earlier gestational age at diagnosis, the lethality of heart disease, and extracardiac or genetic abnormalities, but not its complexity if prenatal diagnosis and parental counseling are provided at a cardiovascular-specialized facility.
摘要：
胎儿心脏病的产前诊断可能会影响父母终止妊娠的决策。现有文献表明，严重性，无论是复杂性还是杀伤力，显著影响父母关于堕胎的决定。然而,关于胎儿心脏病严重程度如何影响父母决定的问题仍然存在，鉴于近期在术后结局方面的进展。因此,我们调查了胎儿心脏病产前诊断后与父母决定流产相关的危险因素.我们的分析包括妊娠22周前诊断为胎儿心脏病的73例（终止：n=37；续：n=36）妊娠。诊断时胎龄的增加降低了父母决定终止妊娠的可能性(模型1:调整后的比值比，0.94；95%置信区间0.89-0.99；模型2：0.950.90-0.997）。危重病（5.25;1.09-25.19）和并发心外或遗传异常（模型1：4.19，1.21-14.53；模型2：5.47，1.50-19.96）增加了选择流产的可能性。值得注意的是,复杂疾病对父母决定没有显著影响(0.56;0.14-2.20).这些结果表明，父母关于流产的决策可能会受到诊断时早期胎龄的影响。心脏病的致命性,心外或遗传异常，但如果产前诊断和父母咨询是在心血管专业机构提供的，则不是其复杂性。
