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Variables Influencing Pregnancy Termination Following Prenatal Diagnosis of Fetal Chromosome Abnormalities
Authors:Anne Hawkins  Ana Stenzel  Joanne Taylor  Valerie Y. Chock  Louanne Hudgins
Affiliation:1. Stanford University Perinatal Genetics, Stanford, CA, USA
2. Perinatal Diagnostic Center at Salinas, 212 San Jose Street Suite 311, Salinas, CA, 93901, USA
Abstract:The objective of this study was to identify variables that may influence the decision to terminate or continue a pregnancy affected by a chromosome abnormality. We performed a retrospective cohort analysis of 286 pregnancies diagnosed with a chromosome abnormality following genetic counseling and prenatal diagnosis. Data obtained included procedure type, chromosome results, ethnicity, maternal age, use of fertility treatments, and uptake of genetic counseling after results, among other factors. Wilcoxon rank sum test, Fisher’s exact test, and univariate and multivariate logistic regression models were used for data analysis. The overall termination rate in this study was 82.9 %. A lower likelihood to terminate was found in pregnancies with a diagnosis of a sex chromosome abnormality (OR 0.05, p?p?=?.03), and uptake of second genetic counseling session (OR 0.05, p?p?=?.02). Factors revealing no statistically significant association with termination included maternal age, gestational age, clinic site, fetal gender, ultrasound anomalies, reason for referral and who informed the patient. Our data affirm the complexity of the decision making process and reinforce that providers should refrain from making assumptions regarding a patient’s likelihood to terminate based on factors such as maternal age, gestational age, type of procedure, or ultrasound.
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