Po Lam So1, Kwun Yue Yvonne Cheng2, Kwan Yiu Cheuk3, Wan Kam Chiu4, Shui Lam Mak5, Sau Lan Mok6, Tsz Kin Lo7, Wai Kuen Yung8, Fai Man Lo9, Hon Yin Brian Chung10, Sik Yau Anita Kan7,11, Chin Peng Lee11,12, Hoi Yin Mary Tang11,12. 1. Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, SAR, China. 2. Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hong Kong, SAR, China. 3. Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, SAR, China. 4. Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, SAR, China. 5. Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, SAR, China. 6. Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, SAR, China. 7. Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong, SAR, China. 8. Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, SAR, China. 9. Clinical Genetic Service, Department of Health, Hong Kong, SAR, China. 10. Departments of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, SAR, China. 11. Prenatal Diagnostic and Counselling Division, Tsan Yuk Hospital, Hong Kong, SAR, China. 12. Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, SAR, China.
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.
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.
Authors: Julio Alejandro Peña Duque; Charles Francisco Ferreira; Suzana de Azevedo Zachia; Maria Teresa Vieira Sanseverino; Rejane Gus; José Antônio de Azevedo Magalhães Journal: Genet Mol Biol Date: 2019-06-03 Impact factor: 1.771