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法国南部医生对产前诊断后终止妊娠的接受度。

Physicians' acceptability of termination of pregnancy after prenatal diagnosis in southern France.

作者信息

Julian C, Huard P, Gouvernet J, Mattéi J F, Aymé S

机构信息

INSERM U242, Centre de G/57enétique Médicale, Hôpital d'enfants de la Timone, Marseille, France.

出版信息

Prenat Diagn. 1989 Feb;9(2):77-89. doi: 10.1002/pd.1970090202.

Abstract

The acceptability of prenatal diagnosis for Down's syndrome has been extensively studied over the last 15 years but that of other pathologies remains largely unexplored. The main goals of this study were to approach physicians' opinions on six reasons for termination of pregnancy showing different deficiencies, i.e., Down's, Turner and Klinefelter syndromes, cystic fibrosis, spina bifida, and haemophilia, and to identify the origins of reserves. The influence of sociodemographic and professional characteristics of physicians on their opinions and attitudes during the consultation were studied. The data presented are based on information gathered in 1985 by a mailed questionnaire answered by 853 general practitioners, gynaecologists, obstetricians, and pediatricians in the Marseilles Genetic Centre's region. Stepwise logistic regression was used for the multivariate analysis. The results showed that 78 per cent of those answering favour termination of pregnancy for Down's syndrome and that only moral reticences were mentioned by the physicians opposed. Conversely, for haemophilia, only 21 per cent of the physicians considered this indication justified; those opposed were for the most part concerned that severity of illness did not justify termination of pregnancy. Overall, 33 per cent of physicians would voice their personal opinion on termination of pregnancy if so requested by consultees. Results on the influence of age and specialty evidenced their role on physicians' opinions. Indeed, 30 per cent of physicians opposed to pregnancy termination for one of the six fetal anomalies retained herein would modify their positions if diagnosis were possible in the first trimester of pregnancy.

摘要

在过去15年里,人们对唐氏综合征产前诊断的可接受性进行了广泛研究,但对其他病症的可接受性仍 largely unexplored。本研究的主要目的是了解医生对六种不同缺陷的终止妊娠原因的看法,即唐氏、特纳和克兰费尔特综合征、囊性纤维化、脊柱裂和血友病,并确定保留意见的来源。研究了医生的社会人口统计学和专业特征对他们在咨询过程中的意见和态度的影响。所呈现的数据基于1985年通过邮寄问卷收集的信息,该问卷由马赛遗传中心地区的853名全科医生、妇科医生、产科医生和儿科医生回答。采用逐步逻辑回归进行多变量分析。结果显示,78%的受访者赞成因唐氏综合征终止妊娠,而反对的医生只提到了道德上的保留意见。相反,对于血友病,只有21%的医生认为这种指征是合理的;反对的人大多担心疾病的严重程度不足以证明终止妊娠是合理的。总体而言,如果咨询者要求,33%的医生会就终止妊娠表达个人意见。年龄和专业影响的结果证明了它们在医生意见方面的作用。事实上,对于本文中保留的六种胎儿异常之一反对终止妊娠的医生中,30%的人如果在妊娠早期能够进行诊断,会改变他们的立场。

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