Document Detail

Variation in the decision to terminate pregnancy in the setting of fetal aneuploidy.
MedLine Citation:
PMID:  16724363     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the rate of pregnancy termination for various fetal aneuploidies, and to evaluate predictors of this choice. METHODS: A retrospective cohort study identified all patients with any of seven common fetal aneuploidies (trisomies 21, 18, and 13; 45,X, 47,XXX, 47,XXY, and 47,XYY) at a referral prenatal diagnosis unit from 1983 to 2003. We abstracted type of aneuploidy, time and type of diagnostic procedure, maternal age, and ethnicity as predictors of the decision to terminate. Statistical comparisons were made using the chi-square test. Potential confounding variables were controlled for using multivariate logistic regression. RESULTS: Overall, there were 833 patients who had fetuses with aneuploidy. In our study population, the overall rate of termination was 81%: 86% in cases of autosomal trisomy and 60% in cases of sex chromosome aneuploidy (SCA) (p < 0.001). Rates were lowest in cases with the least severe prognosis, 47,XYY (57%) and 47,XXX (40%) compared with 45,X (65%) and 47,XXY (70%) (p = 0.05). Patients with SCA detected by chorionic villus sampling (CVS) had a higher termination rate than those who had undergone amniocentesis (77% vs 55%, p = 0.015). Increased maternal age was associated with higher termination rates in autosomal trisomy (88% vs 76% p < 0.001) and a trend toward decreased rates in those with SCA (55% vs 71%, p = 0.06). Hispanic women were less likely to terminate pregnancy (69%, p = 0.01) than those from other racial/ethnic groups. CONCLUSION: Type and severity of aneuploidy, type of diagnostic procedure, maternal age, and ethnicity contribute to patients' decision-making in the setting of fetal aneuploidy.
Brian L Shaffer; Aaron B Caughey; Mary E Norton
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  26     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-28     Completed Date:  2006-12-12     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  667-71     Citation Subset:  IM    
Division of Perinatal Medicine and Genetics, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94143, USA.
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MeSH Terms
Abortion, Eugenic / psychology*,  statistics & numerical data
Chorionic Villi Sampling
Cohort Studies
Decision Making
Maternal Age
Prenatal Diagnosis / methods
Retrospective Studies
Sex Chromosome Aberrations* / statistics & numerical data
Sex Chromosome Disorders / ethnology,  genetics*
Grant Support

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