Lu Xuning, Li Guoju, Wu Qin, Ni Wei, Pan Silin, Xing Quansheng
Heart Center, Qingdao Women and Children's Hospital, Shandong University, Qingdao, Shandong Province, People's Republic of China.
Heart Center, Dalian Municipal Women and Children's Medical Center (Group), Dalian, Liaoning Province, People's Republic of China.
Risk Manag Healthc Policy. 2024 Jan 20;17:205-212. doi: 10.2147/RMHP.S447493. eCollection 2024.
The outcomes of fetuses with isolated congenital heart disease (CHD) diagnosed prenatally have not been investigated in a population-based study in China. This population-based study aimed to evaluate the rate of voluntary termination of pregnancy after the prenatal diagnosis of isolated CHD in Qingdao, China.
This was a population-based retrospective study in which data were collected from all pregnant women in Qingdao (eastern China) from August 2018 to July 2020; fetal data, maternal data and data on pregnancy outcomes were extracted from medical records regarding prenatal diagnosis of CHD. The inclusion criteria were as follows: pregnant women or their husbands who had a household registration in Qingdao and who underwent regular prenatal screening in Qingdao. The exclusion criterion was the failure to sign an informed consent form. Counseling for all parents of fetuses with CHD was provided by a multidisciplinary team of experienced pediatric cardiologists, obstetricians, geneticists, etc. According to the type and severity of CHD, the pregnancy termination rate was analyzed.
Among the 126,843 pregnant women, 1299 fetuses with a prenatal diagnosis of CHD were included in the study. Among the included fetuses, 1075 were diagnosed with isolated CHD, and the overall pregnancy termination rate was 22.8%. Termination rates varied according to the complexity of CHD (low complexity vs moderate complexity, P=0.000; low complexity vs high complexity, P=0.000; moderate complexity vs high complexity, P=0.000), with rates of 6.0% for low complexity, 54.2% for moderate complexity, and 99.1% for high complexity. The decision to terminate the pregnancy in cases of isolated CHD was unrelated to maternal age (P=0.091) but was related to gestational age (p=0.000).
In Qingdao, 99.1% of parents whose fetuses were diagnosed with isolated high-complexity CHD chose to voluntarily terminate the pregnancy. The pregnancy termination rate increased with increasing complexity of prenatally diagnosed CHD.
在中国一项基于人群的研究中，尚未对产前诊断为孤立性先天性心脏病（CHD）的胎儿结局进行调查。这项基于人群的研究旨在评估中国青岛产前诊断为孤立性CHD后自愿终止妊娠的比例。
这是一项基于人群的回顾性研究，收集了2018年8月至2020年7月青岛（中国东部）所有孕妇的数据；从关于CHD产前诊断的病历中提取胎儿数据、母亲数据和妊娠结局数据。纳入标准如下：在青岛有户籍且在青岛接受常规产前筛查的孕妇或其丈夫。排除标准是未签署知情同意书。由经验丰富的儿科心脏病专家、产科医生、遗传学家等多学科团队为所有患有CHD的胎儿的父母提供咨询。根据CHD的类型和严重程度，分析终止妊娠率。
在126,843名孕妇中，1299例产前诊断为CHD的胎儿被纳入研究。在纳入的胎儿中，1075例被诊断为孤立性CHD，总体终止妊娠率为22.8%。终止妊娠率因CHD的复杂性而异（低复杂性与中度复杂性，P = 0.000；低复杂性与高复杂性，P = 0.000；中度复杂性与高复杂性，P = 0.000），低复杂性为6.0%，中度复杂性为54.2%，高复杂性为99.1%。孤立性CHD病例中终止妊娠的决定与母亲年龄无关（P = 0.091），但与孕周有关（P = 0.000）。
在青岛，胎儿被诊断为孤立性高复杂性CHD的父母中，99.1%选择自愿终止妊娠。产前诊断的CHD复杂性增加，终止妊娠率也随之增加。
