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Parental decisions following prenatal diagnosis of sex chromosome aneuploidy in Hong Kong
Author(s) -
So Po Lam,
Cheng Kwun Yue Yvonne,
Cheuk Kwan Yiu,
Chiu Wan Kam,
Mak Shui Lam,
Mok Sau Lan,
Lo Tsz Kin,
Yung Wai Kuen,
Lo Fai Man,
Chung Hon Yin Brian,
Kan Sik Yau Anita,
Lee Chin Peng,
Tang Hoi Yin Mary
Publication year - 2017
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13451
Subject(s) - medicine , obstetrics , pregnancy , odds ratio , prenatal diagnosis , aneuploidy , advanced maternal age , fetus , infertility , gynecology , retrospective cohort study , univariate analysis , genetic counseling , multivariate analysis , cohort , chromosome , genetics , biology , gene
Abstract Aim According to the published work, pregnancy termination rates due to prenatal diagnosis of fetal sex chromosome aneuploidies (SCA) vary widely. Some potentially modifiable and non‐modifiable factors have been reported to be associated with parental decision. This study aimed to evaluate the rate of pregnancy termination for fetal SCA and the factors influencing parents' decisions in Hong Kong. Methods This was a 21‐year retrospective cohort study of parents' decisions following prenatal diagnosis of SCA. Univariate and multivariate analyses for the association between demographic factors, prenatal factors, or counseling provided and decision‐making were conducted. Results The study included 399 pregnancies with prenatal diagnosis of SCA and the overall termination rate was 55.6% (91.7%, 48.0%, 23.4%, 4.8%, and 22.7% for 45,X, 47,XXY, 47,XXX, 47,XYY, and mosaicism, respectively). Pregnancies with ultrasound abnormalities were associated with higher termination rates than pregnancies with normal ultrasound findings (91.3% vs 28.3%, P < 0.0001). From multivariate regression analysis on 226 pregnancies with normal ultrasound examination, a higher likelihood to terminate was found in pregnancies affected by 45,X and 47,XXY (adjusted odds ratio, 4.72, P < 0.0001). Increased maternal age and history of infertility were associated with lower likelihood to terminate (adjusted odds ratio, 0.9, P = 0.012; and 5.12, P = 0.038, respectively). The pregnancy termination rate declined over time. Conclusion A significant correlation was found between the termination of SCA‐affected pregnancy and the presence of fetal sonographic abnormalities, type of SCA, maternal age, and presence of infertility.