Associated factors with parental pregnancy decision-making and use of consultation after a prenatal congenital heart disease diagnosis
Background: Prenatal diagnosis of congenital heart disease (CHD) often leads affected families to experience psychological stress. Pediatric cardiology consultation is important in providing parents with sufficient information and reducing their anxiety to make an informed pregnancy decision. Involv...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | Pediatrics and Neonatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957222002613 |
| _version_ | 1797776205043204096 |
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| author | Wan-Ling Chih Yu-Hsuan Tung Eric C. Lussier Chan-Yu Sung Yi-Ling Huang Wei-Li Hung Kang-Hong Hsu Chung-I Chang Tung Yao Chang Ming-Ren Chen |
| author_facet | Wan-Ling Chih Yu-Hsuan Tung Eric C. Lussier Chan-Yu Sung Yi-Ling Huang Wei-Li Hung Kang-Hong Hsu Chung-I Chang Tung Yao Chang Ming-Ren Chen |
| author_sort | Wan-Ling Chih |
| collection | DOAJ |
| description | Background: Prenatal diagnosis of congenital heart disease (CHD) often leads affected families to experience psychological stress. Pediatric cardiology consultation is important in providing parents with sufficient information and reducing their anxiety to make an informed pregnancy decision. Involving a fetal nurse coordinator may optimize fetal anomaly care. Our study aimed to identify factors associated with parental decision-making for choosing to use pediatric cardiology consultations and pregnancy termination. Methods: From September 2017 to December 2018, all fetal CHD cases diagnosed in the second trimester from a primary screening clinic in Taiwan were included (n = 145). Univariate and multivariate logistic regression were performed to analyze maternal, fetal, and medical factors for predictors of parental decisions for consultation use and pregnancy termination. Results: Acceptance for fetal nurse coordinator care and pediatric cardiology consultation were 84.8% (n = 123) and 83.4% (n = 121), respectively. Predictors for termination of pregnancy included the following: multiple anomalies (OR: 10.6; 95% CI: 3.6–35.7), chromosomal/genetic abnormalities (OR: 20.2; 95% CI: 3.1–395.8), severe CHDs (OR: 9.8; 95% CI: 4.3–23.4), CHDs that required surgery (OR: 32.4; 95% CI: 11.4–117.8), and physiological single-ventricle (OR: 47.3; 95% CI: 12.4–312.5). Parents who had pediatric cardiology counseling were less likely to terminate the pregnancy (OR: 0.1; 95% CI: 0.0–0.7). Parents with fetal diagnosis having multiple anomalies (OR: 0.2; 95% CI: 0.1–0.7) or chromosomal/genetic abnormalities (OR: 0.1; 95% CI: 0.03–0.9) were less likely to make use of cardiology consultation. Parents who accepted fetal nurse coordinator care were more likely to have pediatric cardiology consultation before pregnancy decision (OR: 149.5, 95% CI: 37.8–821.5). Conclusions: Anomaly complexity appeared to be a strong predictor for termination of pregnancy beyond non-acceptability of prenatal cardiology consultation. Prenatal cardiology counseling may help support the parental decision to continue with the pregnancy. Incorporation of a fetal nurse coordinator care into the multidisciplinary fetal medicine team improved the acceptability of prenatal consultation. |
| first_indexed | 2024-03-12T22:46:36Z |
| format | Article |
| id | doaj.art-de9fbafd18fc476a88627d196c65c061 |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-03-12T22:46:36Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-de9fbafd18fc476a88627d196c65c0612023-07-21T04:59:27ZengElsevierPediatrics and Neonatology1875-95722023-07-01644371380Associated factors with parental pregnancy decision-making and use of consultation after a prenatal congenital heart disease diagnosisWan-Ling Chih0Yu-Hsuan Tung1Eric C. Lussier2Chan-Yu Sung3Yi-Ling Huang4Wei-Li Hung5Kang-Hong Hsu6Chung-I Chang7Tung Yao Chang8Ming-Ren Chen9Taiji Clinic, Taipei, Taiwan; Department of Pediatrics, MacKay Memorial Hospital, Taipei, TaiwanTaiji Clinic, Taipei, TaiwanTaiji Clinic, Taipei, TaiwanTaiji Clinic, Taipei, TaiwanTaiji Clinic, Taipei, TaiwanDepartment of Pediatrics, MacKay Memorial Hospital, Taipei, TaiwanDivision of Cardiovascular Surgery, Department of Surgery, MacKay Memorial Hospital, Taipei, TaiwanDivision of Cardiovascular Surgery, Department of Surgery, MacKay Memorial Hospital, Taipei, TaiwanTaiji Clinic, Taipei, TaiwanDepartment of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan; Corresponding author. No.92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City 104, TaiwanBackground: Prenatal diagnosis of congenital heart disease (CHD) often leads affected families to experience psychological stress. Pediatric cardiology consultation is important in providing parents with sufficient information and reducing their anxiety to make an informed pregnancy decision. Involving a fetal nurse coordinator may optimize fetal anomaly care. Our study aimed to identify factors associated with parental decision-making for choosing to use pediatric cardiology consultations and pregnancy termination. Methods: From September 2017 to December 2018, all fetal CHD cases diagnosed in the second trimester from a primary screening clinic in Taiwan were included (n = 145). Univariate and multivariate logistic regression were performed to analyze maternal, fetal, and medical factors for predictors of parental decisions for consultation use and pregnancy termination. Results: Acceptance for fetal nurse coordinator care and pediatric cardiology consultation were 84.8% (n = 123) and 83.4% (n = 121), respectively. Predictors for termination of pregnancy included the following: multiple anomalies (OR: 10.6; 95% CI: 3.6–35.7), chromosomal/genetic abnormalities (OR: 20.2; 95% CI: 3.1–395.8), severe CHDs (OR: 9.8; 95% CI: 4.3–23.4), CHDs that required surgery (OR: 32.4; 95% CI: 11.4–117.8), and physiological single-ventricle (OR: 47.3; 95% CI: 12.4–312.5). Parents who had pediatric cardiology counseling were less likely to terminate the pregnancy (OR: 0.1; 95% CI: 0.0–0.7). Parents with fetal diagnosis having multiple anomalies (OR: 0.2; 95% CI: 0.1–0.7) or chromosomal/genetic abnormalities (OR: 0.1; 95% CI: 0.03–0.9) were less likely to make use of cardiology consultation. Parents who accepted fetal nurse coordinator care were more likely to have pediatric cardiology consultation before pregnancy decision (OR: 149.5, 95% CI: 37.8–821.5). Conclusions: Anomaly complexity appeared to be a strong predictor for termination of pregnancy beyond non-acceptability of prenatal cardiology consultation. Prenatal cardiology counseling may help support the parental decision to continue with the pregnancy. Incorporation of a fetal nurse coordinator care into the multidisciplinary fetal medicine team improved the acceptability of prenatal consultation.http://www.sciencedirect.com/science/article/pii/S1875957222002613Congenital heart diseasePrenatal consultationPrenatal counselingPrenatal diagnosisTermination of pregnancy |
| spellingShingle | Wan-Ling Chih Yu-Hsuan Tung Eric C. Lussier Chan-Yu Sung Yi-Ling Huang Wei-Li Hung Kang-Hong Hsu Chung-I Chang Tung Yao Chang Ming-Ren Chen Associated factors with parental pregnancy decision-making and use of consultation after a prenatal congenital heart disease diagnosis Pediatrics and Neonatology Congenital heart disease Prenatal consultation Prenatal counseling Prenatal diagnosis Termination of pregnancy |
| title | Associated factors with parental pregnancy decision-making and use of consultation after a prenatal congenital heart disease diagnosis |
| title_full | Associated factors with parental pregnancy decision-making and use of consultation after a prenatal congenital heart disease diagnosis |
| title_fullStr | Associated factors with parental pregnancy decision-making and use of consultation after a prenatal congenital heart disease diagnosis |
| title_full_unstemmed | Associated factors with parental pregnancy decision-making and use of consultation after a prenatal congenital heart disease diagnosis |
| title_short | Associated factors with parental pregnancy decision-making and use of consultation after a prenatal congenital heart disease diagnosis |
| title_sort | associated factors with parental pregnancy decision making and use of consultation after a prenatal congenital heart disease diagnosis |
| topic | Congenital heart disease Prenatal consultation Prenatal counseling Prenatal diagnosis Termination of pregnancy |
| url | http://www.sciencedirect.com/science/article/pii/S1875957222002613 |
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