Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA.
Genet Med. 2012 Jan;14(1):27-38. doi: 10.1038/gim.0b013e31822e57a7. Epub 2011 Oct 7.
We performed a systematic review of factors affecting parental decisions to continue or terminate a pregnancy after prenatal diagnosis of a sex chromosome abnormality, as reported in published studies from 1987 to May 2011. Based on the Matrix Method for systematic reviews, 19 studies were found in five electronic databases, meeting specific inclusion/exclusion criteria. Abstracted data were organized in a matrix. Alongside the search for factors influencing parental decisions, each study was judged on its methodological quality and assigned a methodological quality score. Decisions either to terminate or to continue a sex chromosome abnormality-affected pregnancy shared five similar factors: specific type of sex chromosome abnormality, gestational week at diagnosis, parents' age, providers' genetic expertise, and number of children/desire for (more) children. Factors unique to termination decisions included parents' fear/anxiety and directive counseling. Factors uniquely associated with continuation decisions were parents' socioeconomic status and ethnicity. The studies' average methodological quality score was 10.6 (SD = 1.67; range, 8-14). Findings from this review can be useful in adapting and modifying guidelines for genetic counseling after prenatal diagnosis of a sex chromosome abnormality. Moreover, improving the quality of future studies on this topic may allow clearer understanding of the most influential factors affecting parental decisions.
我们对 1987 年至 2011 年 5 月期间已发表的研究报告进行了系统综述，分析了影响父母决定继续或终止产前诊断出性染色体异常胎儿妊娠的因素。根据系统综述矩阵方法，在五个电子数据库中找到了 19 项研究，这些研究符合特定的纳入/排除标准。提取的数据以矩阵形式组织。除了寻找影响父母决定的因素外，我们还根据方法学质量对每项研究进行了评估，并给出了方法学质量评分。决定终止或继续患有性染色体异常的妊娠有五个相似的因素：性染色体异常的具体类型、诊断时的孕周、父母的年龄、提供者的遗传专业知识，以及孩子的数量/（想要）孩子的数量。与终止决定相关的独特因素包括父母的恐惧/焦虑和指令性咨询。与继续决定相关的独特因素是父母的社会经济地位和种族。这些研究的平均方法学质量评分为 10.6（标准差=1.67；范围 8-14）。本综述的研究结果有助于适应和修改性染色体异常产前诊断后的遗传咨询指南。此外，提高未来关于这一主题的研究质量可能有助于更清楚地了解影响父母决定的最具影响力的因素。
