产前诊断胎儿心脏病孕妇及家庭对妊娠态度影响因素的分析

发布时间：2018-07-27 10:27

【摘要】：目的探讨产前诊断心脏病的胎儿,孕妇及其家庭选择终止妊娠的影响因素。方法 2011年1月至2014年12月在上海第一妇婴保健院胎儿医学部经超声心动图确诊的心脏病胎儿。每个胎儿家庭接受了多学科咨询会诊,被详细告知疾病的诊断、严重程度、治疗策略和远期预后。回顾性收集孕妇及胎儿的详细临床资料和家庭最终的妊娠选择,行多因素Logistics回归分析,探讨孕妇及家庭选择终止妊娠的主要影响因素。结果 162例胎儿进入分析,平均孕周26.5(17.4~39.5)周,24例(14.8%)胎儿合并有显著心脏外畸形。67例(41.4%)孕妇及家庭选择终止妊娠,其中罹患轻度、中度及重度心脏病胎儿中,孕妇及家庭选择终止妊娠的比例分别为16.0%、51.1%和76.2%;合并有显著心脏外畸形的胎儿中,终止妊娠率高达79.2%。多因素Logistic回归分析显示,胎儿心脏病的严重程度(OR=9.001,95%CI:4.143~19.557,P0.001),是否合并有显著心脏外畸形(OR=3.801,95%CI:1.814~7.962,P0.001)及诊断孕周(OR=0.750,95%CI:0.653~0.861,P0.001)是影响孕妇及其家庭选择终止妊娠的3个主要因素。结论对于合并有重度心脏病或显著心脏外畸形胎儿,孕妇及其家庭更倾向于选择终止妊娠。
[Abstract]:Objective to investigate the influencing factors of fetal, pregnant women and their families in prenatal diagnosis of heart disease. Methods from January 2011 to December 2014, the fetus with heart disease was diagnosed by echocardiography in the Fetal Medicine Department of Shanghai first Maternal and Infant Health Care Hospital. Each foetus family received a multidisciplinary consultation and was informed of the diagnosis, severity, treatment strategy and long-term prognosis of the disease. The clinical data of pregnant women and fetuses and the family's final pregnancy choice were collected retrospectively. Multivariate Logistics regression analysis was carried out to explore the main influencing factors of pregnant women and families' choice of termination of pregnancy. Results among 162 fetuses, the average gestational age was 26.5 (17.4 / 39.5) weeks, 24 (14.8%) fetuses were complicated with significant extracardiac malformations. 67 (41.4%) pregnant women and their families chose to terminate their pregnancies. Among them, the fetuses suffered from mild, moderate and severe heart disease. The proportion of pregnant women and families who chose to terminate pregnancy was 16.0% and 76.22.The termination rate of pregnancy was 79.2% in the fetuses with significant extracardiac malformations. Multivariate Logistic regression analysis showed that the severity of fetal heart disease (OR 9.001C 95 CI: 4.143C 19.557 P0.001), the presence of significant extracardiac malformation (OR 3.801C 95 CI 1.814C 7.962P0.001) and the diagnosis of gestational week (OR0.75095CI0.6530.861P0.001) were the three main factors affecting the choice of termination of pregnancy by pregnant women and their families. Conclusion pregnant women and their families are more likely to choose termination of pregnancy for fetus with severe heart disease or significant extracardiac malformation.
【作者单位】：复旦大学附属儿科医院心血管中心;同济大学附属上海市第一妇婴保健院胎儿医学部;上海位育高级中学;复旦大学附属儿科医院临床流行病学教研室;
【分类号】：R714.5

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