Clinical and socioeconomic predictors of pregnancy termination for fetuses with congenital heart defects: a population‐based evaluation
K Tararbit, TTT Bui, N Lelong, AC Thieulin… - Prenatal …, 2013 - Wiley Online Library
Prenatal Diagnosis, 2013•Wiley Online Library
Objectives This study aims to (1) evaluate the probability and timing of termination of
pregnancy for fetal anomaly (TOPFA) for all congenital heart defects (CHD) and categories
of CHD and (2) assess clinical and socioeconomic predictors of TOPFA for isolated CHD
excluding ventricular septal defects (VSD). Methods Using population‐based data from the
Paris Registry of Congenital Malformations, we assessed the probability of TOPFA and
gestational age at TOPFA. We used logistic regression to estimate the adjusted effects of …
pregnancy for fetal anomaly (TOPFA) for all congenital heart defects (CHD) and categories
of CHD and (2) assess clinical and socioeconomic predictors of TOPFA for isolated CHD
excluding ventricular septal defects (VSD). Methods Using population‐based data from the
Paris Registry of Congenital Malformations, we assessed the probability of TOPFA and
gestational age at TOPFA. We used logistic regression to estimate the adjusted effects of …
Objectives
This study aims to (1) evaluate the probability and timing of termination of pregnancy for fetal anomaly (TOPFA) for all congenital heart defects (CHD) and categories of CHD and (2) assess clinical and socioeconomic predictors of TOPFA for isolated CHD excluding ventricular septal defects (VSD).
Methods
Using population‐based data from the Paris Registry of Congenital Malformations, we assessed the probability of TOPFA and gestational age at TOPFA. We used logistic regression to estimate the adjusted effects of maternal characteristics, clinical factors (CHD type, fetal growth restriction, nuchal translucency measurement and gestational age at prenatal diagnosis) on the odds of TOPFA.
Results
The proportion of TOPFA for prenatally diagnosed CHD was 46% for all CHD combined, 82% for CHD associated with chromosomal anomalies and 27% for isolated CHD‐VSD excluded. Isolated CHD‐VSD excluded diagnosed before 22 weeks of gestational age had a 3.2‐fold higher odds of TOPFA (adjusted OR 3.2, 95%CI 1.4–7.1). Maternal occupation was not associated with the odds of TOPFA. Women of African origin had a tenfold lower odds of TOPFA than women of French origin (adjusted OR 0.1, 95%CI 0.02–0.4).
Conclusion
In addition to severity of CHD, early prenatal diagnosis and maternal characteristics were highly associated with the probability of TOPFA for CHD. © 2013 John Wiley & Sons, Ltd.
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