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内华达州对重大先天性心脏病的产前诊断和选择性终止妊娠。

Prenatal diagnosis of significant congenital heart disease and elective termination of pregnancy in Nevada.

机构信息

Congenital Heart Center Nevada, Las Vegas, NV, USA.

Division of Pediatric Cardiology, Department of Pediatrics, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV, USA.

出版信息

J Matern Fetal Neonatal Med. 2022 Dec;35(25):8761-8766. doi: 10.1080/14767058.2021.2004115. Epub 2021 Nov 23.

Abstract

OBJECTIVE

We investigated the relationship between prenatal detection of significant congenital heart disease and elective termination of pregnancy over time in Nevada.

METHODS

We identified those prenatally or post-natally diagnosed with significant congenital cardiovascular malformations in Nevada with birth dates or estimated delivery dates between July 2012 and June 2021.

RESULTS

We identified 1246. Of 1246, 69 underwent fetal demise, 42 had elective termination, and 1135 were live-born. Of the 1135 live-born, 1090 had prenatal care, of which 718 (66%) overall had a prenatal diagnosis of significant congenital heart disease. However, prenatal detection statistically significantly increased over time from 45 to 82%,  = .00001. Termination of pregnancy averaged 10% of those identified within the legal timeframe, and the rate did not statistically significantly increase with increasing prenatal detection rates,  = .56. Of the 42 undergoing elective termination, 23 (55%) had syndromes or comorbidities 280 (25%) of the 1135 live-births, = .0003.

CONCLUSIONS

In Nevada, despite a statistically significant increase in prenatal detection of significant congenital heart disease over time, termination of pregnancy rates did not increase. Nevertheless, those undergoing elective termination were more likely to have associated syndromes or comorbidities.

摘要

目的

我们研究了内华达州随时间推移产前检测到显著先天性心脏病与选择性终止妊娠之间的关系。

方法

我们确定了在 2012 年 7 月至 2021 年 6 月期间在该州出生或估计分娩日期的患有显著先天性心血管畸形的胎儿。

结果

我们确定了 1246 例。在这 1246 例中,有 69 例发生胎儿死亡,42 例进行了选择性终止妊娠,1135 例为活产。在这 1135 例活产中,有 1090 例接受了产前护理,其中 718 例(66%)总体上产前诊断为显著先天性心脏病。然而,随时间推移,产前检测的比例从 45%增加到 82%,统计学上有显著差异,=0.00001。在合法的时间范围内确定的那些人中,终止妊娠的平均比例为 10%,且随着产前检测率的增加,其比例并没有统计学上的显著增加,=0.56。在进行选择性终止妊娠的 42 例中,有 23 例(55%)患有综合征或合并症,而在 1135 例活产中,有 280 例(25%)患有综合征或合并症,=0.0003。

结论

在内华达州,尽管随时间推移产前检测到显著先天性心脏病的比例呈统计学显著增加,但终止妊娠的比例并未增加。尽管如此,那些进行选择性终止妊娠的患者更有可能存在相关综合征或合并症。

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