TY - JOUR
T1 - Factors That Influence Parents’ Decision-Making Regarding Termination of Pregnancy After Prenatal Diagnosis of Fetal Congenital Heart Disease
AU - Gendler, Yulia
AU - Birk, Einat
AU - Tabak, Nili
AU - Koton, Silvia
N1 - Publisher Copyright:
© 2021 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
PY - 2021/7
Y1 - 2021/7
N2 - Objective: To explore factors that influence parents’ decisions regarding the termination of pregnancy after the detection of fetal congenital heart disease (CHD). Design: A prospective descriptive study. Setting: The Institute of Pediatric Cardiology in the Schneider Children's Medical Center. Participants: One hundred twenty couples (240 participants) with fetuses prenatally diagnosed with CHD, which was defined as conditions requiring surgical treatment. Methods: We obtained data from a structured questionnaire for the pediatric cardiologist, the medical records, and structured self-report questionnaires for the participants. Results: 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]). Conclusions: 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.
AB - Objective: To explore factors that influence parents’ decisions regarding the termination of pregnancy after the detection of fetal congenital heart disease (CHD). Design: A prospective descriptive study. Setting: The Institute of Pediatric Cardiology in the Schneider Children's Medical Center. Participants: One hundred twenty couples (240 participants) with fetuses prenatally diagnosed with CHD, which was defined as conditions requiring surgical treatment. Methods: We obtained data from a structured questionnaire for the pediatric cardiologist, the medical records, and structured self-report questionnaires for the participants. Results: 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]). Conclusions: 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.
KW - CHD
KW - TOP
KW - congenital heart disease
KW - decision-making
KW - parental decision
KW - prospective study
KW - termination of pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85109449283&partnerID=8YFLogxK
U2 - 10.1016/j.jogn.2021.04.002
DO - 10.1016/j.jogn.2021.04.002
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C2 - 33991490
AN - SCOPUS:85109449283
SN - 0884-2175
VL - 50
SP - 475
EP - 484
JO - JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
JF - JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
IS - 4
ER -