Factors influencing parental pregnancy decision-making due to fetuses with non-syndromic orofacial clefts: a study of Chinese couples

Abstract

Factors influencing parental pregnancy decision-making due to fetuses with non-syndromic orofacial clefts: a study of Chinese couples Huanhuan Ding1 , Weizeng Zheng2 , Xinfen Xu3,*, Baohua Li4 1Neonatal Intensive Care Unit, Women’s Hospital, School of Medicine, Zhejiang University, 310006 Hangzhou, Zhejiang, China 2Department of Radiology, Women’s Hospital, School of Medicine, Zhejiang University, 310006 Hangzhou, Zhejiang, China 3Adminitrative Office, Women’s Hospital, School of Medicine, Zhejiang University, Haining Branch, 314400 Hangzhou, Zhejiang, China 4Department of Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, 310006 Hangzhou, Zhejiang, China *Correspondence: xuxinf@zju.edu.cn (Xinfen Xu) Academic Editor: Michael H. Dahan Submitted: 18 March 2021 Revised: 5 June 2021 Accepted: 11 June 2021 Published: 11 January 2022 Abstract Background: When a fetus is diagnosed with facial deformities, most Chinese couples choose to terminate the pregnancy. However, these couples commonly regret their decision after the termination of the pregnancy, display a heavier degree of grief, and these feelings persist for a long time. The purpose of this study was to investigate factors that influence parental pregnancy decisions regarding fetuses diagnosed with a non-syndromic orofacial cleft (NSOFC), and to provide the preliminary basis for a formulation of interview outlines useful in further qualitative research in this area. Methods: We collected medical records of 400 couples from the obstetrical units of a women’s hospital in China whose fetuses were diagnosed with Orofacial clefts (OFCs) from January 2013 to July 2019. After excluding those records reporting chromosomal or other abnormalities, 311 cases were included in this study. After univariate analysis, factors that may have affected the parental pregnancy decision were analyzed using binary classification regression analysis. Results: Among the 311 couples, 71.7% (223/311) decided to terminate the pregnancy, whereas 28.3% (88/311) decided to continue. The registered residence, family history of NSOFC, maternal high-risk factors that may lead to the fetus suffering from NSOFC, maternal age, paternal age, doctor’s suggestion, prenatal diagnosis, and first diagnosed gestational week all influenced pregnancy decision makings (p < 0.05). Among these, the registered residence, family history of NSOFC, maternal high-risk factors, maternal age, prenatal diagnosis, and first diagnosed gestational week substantially affected the parental pregnancy decision. Discussion: The couples with registered residence in rural areas, no family history of NSOFC, no maternal high-risk factors, younger maternal age, younger gestational age at first diagnosis are at greater relative risk of pregnancy termination. Prenatal diagnosis is a protective factor. Keywords: Fetus; Cleft lip; Cleft palate; Decision-making