| Chromosomal anomalies influence parental treatment decisions in relation to prenatally diagnosed congenital heart disease. | |
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MedLine Citation:
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PMID: 19705187 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study aimed to identify the variables that influence parental treatment decisions after a prenatal diagnosis of congenital heart disease (CHD). The authors reviewed all cases of prenatally diagnosed structural CHD from August 1998 to December 2006 at their center. The following variables were studied as potential predictors of parental intent to treat: maternal age, race, insurance status, obstetric history, fetal gender, univentricular versus biventricular cardiac physiology, and fetal chromosomal abnormality. Uni- and multivariable logistic regression analyses were performed. In the review, 252 consecutive cases of prenatally diagnosed CHD were identified. Of these, 204 women pursued full medical treatment, whereas 25 women sought termination of pregnancy or comfort care. Parental intent to treat was unknown for 23 cases. Multivariable logistic regression analysis identified fetal chromosomal abnormality as the only variable that influenced parental intent to treat (odds ratio [OR], 14.33; 95% confidence interval [CI], 3.28-62.66; p = 0.0006). An associated chromosomal abnormality rather than the severity of the heart defect influences the decision to choose termination of pregnancy or comfort care for a fetus with prenatally diagnosed CHD. Women were 14 times more likely to terminate a pregnancy or seek comfort care for a fetus with CHD if a chromosomal abnormality was present. |
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Authors:
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Sinai C Zyblewski; Elizabeth G Hill; Girish Shirali; Andrew Atz; Geoffrey Forbus; Javier Gonzalez; Anthony Hlavacek |
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Publication Detail:
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Type: Journal Article Date: 2009-08-25 |
Journal Detail:
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Title: Pediatric cardiology Volume: 30 ISSN: 1432-1971 ISO Abbreviation: Pediatr Cardiol Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-22 Completed Date: 2010-02-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003849 Medline TA: Pediatr Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1105-11 Citation Subset: IM |
Affiliation:
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Department of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC 29425, USA. chois@musc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Amniocentesis Cardiology Chromosome Aberrations* Confidence Intervals Decision Making* Echocardiography / methods Female Heart Defects, Congenital / diagnosis, embryology, genetics* Humans Infant, Newborn Logistic Models Maternal Age Multivariate Analysis Odds Ratio Parents / psychology* Pregnancy Retrospective Studies Risk Factors Ultrasonography, Prenatal* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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