Literature DB >> 24311520

Our children are not a diagnosis: the experience of parents who continue their pregnancy after a prenatal diagnosis of trisomy 13 or 18.

Jennifer Guon1, Benjamin S Wilfond, Barbara Farlow, Tracy Brazg, Annie Janvier.   

Abstract

Trisomy 13 and trisomy 18 (T13-18) are associated with high rates of perinatal death and with severe disability among survivors. Prenatal diagnosis (PND) may lead many women to terminate their pregnancy but some women choose to continue their pregnancy. We sent 503 invitations to answer a questionnaire to parents who belong to T13 and 18 internet support groups. Using mixed methods, we asked parents about their prenatal experience, their hopes, the life of their affected child, and their family experience. 332 parents answered questions about 272 children; 128 experienced PND. These parents, despite feeling pressure to terminate (61%) and being told that their baby would likely die before birth (94%), chose to continue the pregnancy. Their reasons included: moral beliefs (68%), child-centered reasons (64%), religious beliefs (48%), parent-centered reasons (28%), and practical reasons (6%). At the time of the diagnosis, most of these parents (80%) hoped to meet their child alive. By the time of birth, 25% chose a plan of full interventions. A choice of interventions at birth was associated with fewer major anomalies (P < 0.05). Parents describe "Special" healthcare providers as those who gave balanced and personalized information, respected their choice, and provided support. Parents make decisions to continue a pregnancy and choose a plan of care for their child according to their beliefs and their child's specific medical condition, respectively. Insights from parents' perspective can better enable healthcare providers to counsel and support families.
© 2013 Wiley Periodicals, Inc.

Entities:  

Keywords:  end of life decision-making; ethics; life sustaining interventions; parental opinions; quality of life; trisomy 13; trisomy 18

Mesh:

Year:  2013        PMID: 24311520     DOI: 10.1002/ajmg.a.36298

Source DB:  PubMed          Journal:  Am J Med Genet A        ISSN: 1552-4825            Impact factor:   2.802


  15 in total

1.  Severe Fetal Abnormality and Outcomes of Continued Pregnancies: A French Multicenter Retrospective Study.

Authors:  Marine Bourdens; Julie Tadonnet; Laura Hostalery; Laurent Renesme; Barthélémy Tosello
Journal:  Matern Child Health J       Date:  2017-10

2.  Trisomy 18 syndrome: Towards a balanced approach.

Authors:  Hassan Batees; Khalid A Altirkawi
Journal:  Sudan J Paediatr       Date:  2014

3.  Parent Perspectives of Support Received from Physicians and/or Genetic Counselors Following a Decision to Continue a Pregnancy with a Prenatal Diagnosis of Trisomy 13/18.

Authors:  Stephanie E Wallace; Sara Gilvary; Michael J Smith; Siobhan M Dolan
Journal:  J Genet Couns       Date:  2017-10-27       Impact factor: 2.537

4.  Treatment Decisions for Babies with Trisomy 13 and 18.

Authors:  Isabella Pallotto; John D Lantos
Journal:  HEC Forum       Date:  2017-09

5.  "You Can Carry the Torch Now:" A Qualitative Analysis of Parents' Experiences Caring for a Child with Trisomy 13 or 18.

Authors:  Joshua D Arthur; Divya Gupta
Journal:  HEC Forum       Date:  2017-09

6.  Is preparation a good reason for prenatal genetic testing? Ethical and critical questions.

Authors:  Marsha Michie
Journal:  Birth Defects Res       Date:  2020-03-01       Impact factor: 2.344

7.  A routine tool with far-reaching influence: Australian midwives' views on the use of ultrasound during pregnancy.

Authors:  Kristina Edvardsson; Ingrid Mogren; Ann Lalos; Margareta Persson; Rhonda Small
Journal:  BMC Pregnancy Childbirth       Date:  2015-08-27       Impact factor: 3.007

8.  Negotiating acceptable termination of pregnancy for non-lethal fetal anomaly: a qualitative study of professional perspectives.

Authors:  Lisa Crowe; Ruth H Graham; Stephen C Robson; Judith Rankin
Journal:  BMJ Open       Date:  2018-03-01       Impact factor: 2.692

Review 9.  Ethical language and decision-making for prenatally diagnosed lethal malformations.

Authors:  Dominic Wilkinson; Lachlan de Crespigny; Vicki Xafis
Journal:  Semin Fetal Neonatal Med       Date:  2014-09-05       Impact factor: 3.926

10.  Differences in mortality and morbidity according to gestational ages and birth weights in infants with trisomy 18.

Authors:  Ken Imai; Atsushi Uchiyama; Tomoka Okamura; Mako Ago; Hideyo Suenaga; Eri Sugita; Hideko Ono; Kyoko Shuri; Kenichi Masumoto; Satsuki Totsu; Hidehiko Nakanishi; Satoshi Kusuda
Journal:  Am J Med Genet A       Date:  2015-08-26       Impact factor: 2.802

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