Pregnancy termination following prenatal diagnosis of anencephaly or spina bifida: a systematic review of the literature

Details

• Alternative Title:
  Birth Defects Res A Clin Mol Teratol
• Personal Author:
  Johnson, Candice Y. ; Honein, Margaret A. ; Flanders, W. Dana ; Howards, Penelope P. ; Oakley, Godfrey P. ; Rasmussen, Sonja A.
• Description:
  Background
  
  In regions where prenatal screening for anencephaly and spina bifida is widespread, many cases of these defects are prenatally diagnosed. The purpose of this study was to estimate the frequency of termination of pregnancy (TOP) following prenatal diagnosis of anencephaly or spina bifida and to investigate factors associated with TOP that might lead to selection bias in epidemiologic studies.
  
  Methods
  
  We included articles indexed in Medline and Embase between 1990 and May 2012 reporting the frequency of TOP following prenatal diagnosis of anencephaly or spina bifida with English-language abstracts, ≥20 prenatally diagnosed cases, and at least half of the study years in 1990 or later. We summarized the frequency of TOP across studies using random-effects meta-analysis and stratified results by fetal and study characteristics.
  
  Results
  
  Among the 17 studies identified, 9 included anencephaly and 15 included spina bifida. Nine were from Europe, 6 were from North America, and 1 each was from South America and Asia. The overall frequency of TOP following prenatal diagnosis was 83% for anencephaly (range: 59–100%) and 63% for spina bifida (range: 31–97%). There were insufficient data to stratify the results for anencephaly; TOP for spina bifida was more common when the prenatal diagnosis occurred <24 weeks gestation, with defects of greater severity, and in Europe versus North America.
  
  Conclusions
  
  Because underascertainment of birth defects might be more likely when the pregnancy ends in TOP and TOP is associated with fetal characteristics, selection bias is possible in epidemiologic studies of anencephaly or spina bifida.
  
  
• Subjects:
  Abortion, Induced Americas Anencephaly Article Asia Europe Female Gestational Age Humans Meta-analysis Pregnancy Prenatal Diagnosis Publication Bias Spina Bifida Spinal Dysraphism Termination Of Pregnancy

  More +
• Source:
  Birth Defects Res A Clin Mol Teratol. 94(11):857-863
• Pubmed ID:
  23097374
• Pubmed Central ID:
  PMC4589245
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  94
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:cbb8106fab16c347589e4fc21e7fba62ffac58f21bc8dcc9a609223e507b55aa
• Download URL:
  https://stacks.cdc.gov/view/cdc/34639/cdc_34639_DS1.pdf
• File Type:
  [PDF - 169.37 KB ]