Parental information about the option to apply for pregnancy termination after the detection of a congenital abnormality and factors influencing parental decision-making: a cohort study

Karina Hjort-Pedersen; Annette Wind Olesen; Ester Garne; Pernille Mathiesen Toerring; Chunsen Wu; Lene Sperling

doi:10.1186/s12884-022-05255-0

Parental information about the option to apply for pregnancy termination after the detection of a congenital abnormality and factors influencing parental decision-making: a cohort study

BMC Pregnancy Childbirth. 2022 Dec 17;22(1):948. doi: 10.1186/s12884-022-05255-0.

Authors

Karina Hjort-Pedersen^{1

2

3}, Annette Wind Olesen^{4

5}, Ester Garne⁶, Pernille Mathiesen Toerring⁷, Chunsen Wu^{8

4}, Lene Sperling^{4

5}

Affiliations

¹ Research Unit of Gynaecology and Obstetrics, Odense University Hospital, University of Southern Denmark, Odense, Denmark. Karina.Hjort-Pedersen2@rsyd.dk.
² Odense Patient Data Explorative Network, OPEN, Odense University Hospital, Odense, Denmark. Karina.Hjort-Pedersen2@rsyd.dk.
³ Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Karina.Hjort-Pedersen2@rsyd.dk.
⁴ Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
⁵ Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.
⁶ Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark.
⁷ Department of Clinical Genetics, Odense University Hospital, Odense, Denmark.
⁸ Research Unit of Gynaecology and Obstetrics, Odense University Hospital, University of Southern Denmark, Odense, Denmark.

Abstract

Background: The detection of an abnormality during prenatal screening implies that the parents are informed about possible treatment and management of the pregnancy, birth, and postnatal course. This information should enable the parents to make decisions regarding the pregnancy, especially in cases where termination of pregnancy may be an option. The objectives of this study were to investigate how often doctors informed parents about pregnancy termination when the fetus had an anomaly and which demographic factors were related to parental decision-making.

Methods: This was a retrospective cohort study with prospectively collected data of fetuses diagnosed with an abnormality during prenatal screening between 2014 and 2016 in Denmark. We categorized the abnormalities into five long-term prognosis groups and analyzed their association with the doctor provided information about termination. We tested the association between demographic variables and parental decisions using univariate and multivariate statistical analyses.

Results: Three hundred and twenty fetuses were diagnosed with an abnormality. In 67% of these cases, the parents were informed about termination. All parents whose fetus had a lethal prognosis were informed about termination. By comparison, the parents of 98% of fetuses with genetic disorders, 96% of fetuses with poor prognosis, 69% of fetuses with uncertain prognosis, and 12% of fetuses with good prognosis were informed about termination. Of these parents, 92% chose to terminate. A lethal long-term prognosis was the only factor related to parental decision to terminate a pregnancy.

Conclusions: Doctors mainly informed parents about the option of pregnancy termination for conditions with a poor or lethal long-term prognosis or for genetic disorders. Only conditions with a lethal prognosis were significantly related to the parental decision to terminate the pregnancy.

Keywords: Congenital abnormalities; Parental decision; Prenatal screening; Termination of pregnancy; Ultrasound.

MeSH terms

Abortion, Induced*
Cohort Studies
Congenital Abnormalities* / diagnosis
Decision Making
Female
Humans
Parents
Pregnancy
Prenatal Diagnosis
Retrospective Studies

Abstract

MeSH terms

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