J Obstet Gynecol Neonatal Nurs. 2021 Jul;50(4):475-484. doi: 10.1016/j.jogn.2021.04.002. Epub 2021 May 13.
To explore factors that influence parents' decisions regarding the termination of pregnancy after the detection of fetal congenital heart disease (CHD).
A prospective descriptive study.
The Institute of Pediatric Cardiology in the Schneider Children's Medical Center.
One hundred twenty couples (240 participants) with fetuses prenatally diagnosed with CHD, which was defined as conditions requiring surgical treatment.
We obtained data from a structured questionnaire for the pediatric cardiologist, the medical records, and structured self-report questionnaires for the participants.
Thirty-six of 120 couples (30%) decided to terminate the pregnancy after a prenatal diagnosis of fetal CHD. The main factors associated with the decision to terminate were low gestational age (OR = 0.83 per week, 95% confidence interval [CI] [0.75, 0.96]), severe cardiac malformation (OR = 2.23, 95% CI [1.40, 3.53]), religious affiliation (OR = 10.0 for secular participants vs. others, 95% CI [4.61, 22.46], population group (OR = 2.96 for Jewish participants vs. others, 95% CI [1.63, 11.3]), and education (OR = 1.34 per year of education, 95% CI [1.15, 1.55]).
Our findings describe the profiles of couples who decided to terminate their pregnancies after a prenatal diagnosis of fetal CHD. Early identification of the couple's decision can help health care providers provide adequate support, counseling, and guidance. Future research is needed to understand parents' needs for support through the process of decision-making, with attention to their religious and cultural values and contexts.
探讨影响父母在胎儿先天性心脏病（CHD）检测后决定终止妊娠的因素。
前瞻性描述性研究。
施耐德儿童医疗中心儿科心脏病学研究所。
120 对夫妇（240 名参与者），他们的胎儿在产前被诊断为 CHD，这被定义为需要手术治疗的情况。
我们从儿科心脏病专家的结构化问卷、病历和参与者的结构化自我报告问卷中获取数据。
在 120 对夫妇中，有 36 对（30%）在胎儿 CHD 产前诊断后决定终止妊娠。与终止妊娠决定相关的主要因素是低胎龄（每增加一周，OR=0.83，95%置信区间[CI] [0.75，0.96]）、严重心脏畸形（OR=2.23，95%CI [1.40，3.53]）、宗教信仰（与非宗教参与者相比，OR=10.0，95%CI [4.61，22.46]，人群组（与其他参与者相比，OR=2.96，95%CI [1.63，11.3]）和教育程度（OR=每增加一年教育，OR=1.34，95%CI [1.15，1.55]）。
我们的研究结果描述了决定在胎儿 CHD 产前诊断后终止妊娠的夫妇的特征。早期识别夫妇的决定可以帮助医疗保健提供者提供足够的支持、咨询和指导。需要进一步研究，以了解父母在决策过程中的支持需求，关注他们的宗教和文化价值观和背景。
