[Factors influencing pregnancy decision-making among parents of fetuses with congenital heart disease].

Authors

Xing Mao, Tao Qian, Yuhong Liu, Na Li, Wei Jiang, Zhongshi Wu

Published in

Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences. Volume 51. Issue 5. Pages 861-869. May 28, 2026.

Abstract

In the context of prenatal counseling, the factors influencing pregnancy decision-making among parents of fetuses with congenital heart disease (CHD) remain unclear. This study aims to investigate the factors influencing pregnancy decision-making among parents of fetuses with CHD, with a particular focus on the roles of non-medical factors such as psychological status, socioeconomic status, and the degree of fetal expectation.
A prospective cohort study design was adopted. Expectant parents whose fetuses were prenatally diagnosed with CHD at the Second Xiangya Hospital of Central South University and Hunan Provincial Maternal and Child Health Care Hospital from July 2021 to December 2025, and who received multidisciplinary counseling led by CHD specialists, were enrolled. According to the prognostic risk scoring system, the fetuses were classified into a mild group (0-3 points), a moderate group (4-6 points), and a severe group (7-9 points).Information on the fetuses and parents was collected through questionnaires, and follow-up files were established. Standardized follow-up was conducted at 1 week after counseling, 1 to 2 weeks before the expected date of delivery, and 2 weeks after the expected date of delivery to record the pregnancy outcomes. Multivariate Logistic regression analysis was used to identify independent factors influencing pregnancy decision-making.
A total of 834 families with fetuses prenatally diagnosed with CHD were included. Among them, 522 families (62.6%) chose to continue the pregnancy, whereas 312 families (37.4%) chose to terminate the pregnancy. The severity of fetal disease was the strongest predictor of pregnancy termination. Compared with the mild group, the risk of pregnancy termination in the moderate group increased by 6-fold [adjusted odds ratio (aOR)=6.04, 95% confidence interval (CI) 3.98 to 9.15, P<0.01], and the risk in the severe group increased by 53-fold (aOR=52.97, 95% CI 14.73 to 190.44, P<0.01). Multivariate Logistic regression analysis showed that, after controlling for disease severity, earlier gestational age at diagnosis (aOR=0.76, 95% CI 0.72 to 0.81, P<0.01), older maternal age (aOR=0.96, 95% CI 0.92 to 0.99, P=0.039), multiple pregnancy (aOR=0.24, 95% CI 0.09 to 0.65, P=0.005), higher annual household income (≥200 000 yuan; aOR=0.05, 95% CI 0.01 to 0.21, P<0.01), and a higher degree of fetal expectation (aOR=0.66, 95% CI 0.47 to 0.94, P=0.019) were independent protective factors for continuing pregnancy.
Pregnancy decision-making among parents of fetuses with CHD is a complex process jointly influenced by fetal medical factors, family socioeconomic status, and psychosocial factors. In addition to disease severity, family economic status, and par ental expectations regarding the fetus have important effects on decision-making.

PMID:
42565564
Bibliographic data and abstract were imported from PubMed on 07 Aug 2026.

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