Objective: The purpose of this study was to identify factors that predict a decision to interrupt a pregnancy in which there are fetal anomalies in the second trimester. Study design: The New Jersey Fetal Abnormalitie...
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Objective: The purpose of this study was to identify factors that predict a decision to interrupt a pregnancy in which there are fetal anomalies in the second trimester. Study design: The New Jersey Fetal Abnormalities Registry prospectively recruits and collects information on pregnancies (≥15 weeks of gestation)-from New Jersey residents in whom a fetal structural anomaly has been suspected by maternal-fetal medicine specialists. Enrolled pregnancies that have major fetal structural abnormalities identified from 15 to 23 weeks of gestation were included. Outcomes were classified as either elective interruption or a natural pregnancy course, which might include a spontaneous fetal death or live birth. Predictors of elective interruption of pregnancy were examined with univariable and multivariable logistic regression analyses. Results: Of the 97 cases, 33%of the women (n = 32) interrupted the pregnancy. Significant variables in the regression model that were associated with a decision to interrupt a pregnancy were earlier identification of fetal anomalies (19.0 ±2 weeks of gestation vs 20.5 ±2 weeks of gestation; P=.003), the presence of multiple anomalies (78% 25/32 vs 52% 33/63 ; P = .01 , and a presumption of lethality (56% 18/32 vs 14% 9/65 ; P = .0001). These variables corresponded to an odds ratio for pregnancy interruption of 4.2 (95%CI, 1.0, 17.0) for multiple anomalies, 0.8 (95%CI, 0.7, 1.0) for each week of advancing gestational age, and 36.1 (95%CI, 2.9, 450.7) for presumed lethal abnormalities. Conclusion: Early diagnosis, the identification of multiple abnormalities, and an assessment of likely lethality of fetal anomalies are important factors for the optimization of parental autonomy in deciding pregnancy management.
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