title: Decision to abort after a prenatal diagnosis of sex chromosome abnormality: a systematic review of the literature.
abstract: We performed a systematic review of factors affecting parental decisions to continue or terminate a pregnancy after prenatal diagnosis of a sex chromosome abnormality, as reported in published studies from 1987 to May 2011. Based on the Matrix Method for systematic reviews, 19 studies were found in five electronic databases, meeting specific inclusion/exclusion criteria. Abstracted data were organized in a matrix. Alongside the search for factors influencing parental decisions, each study was judged on its methodological quality and assigned a methodological quality score. Decisions either to terminate or to continue a sex chromosome abnormality-affected pregnancy shared five similar factors: specific type of sex chromosome abnormality, gestational week at diagnosis, parents' age, providers' genetic expertise, and number of children/desire for (more) children. Factors unique to termination decisions included parents' fear/anxiety and directive counseling. Factors uniquely associated with continuation decisions were parents' socioeconomic status and ethnicity. The studies' average methodological quality score was 10.6 (SD = 1.67; range, 8-14). Findings from this review can be useful in adapting and modifying guidelines for genetic counseling after prenatal diagnosis of a sex chromosome abnormality. Moreover, improving the quality of future studies on this topic may allow clearer understanding of the most influential factors affecting parental decisions.
authors.affiliation: Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA. kc_jeon@hlkn.tamu.edu
authors.forename: Kwon Chan
authors.initials: KC
authors.lastname: Jeon
authors.forename: Lei-Shih
authors.initials: LS
authors.lastname: Chen
authors.forename: Patricia
authors.initials: P
authors.lastname: Goodson
mesh_terms: D000028:Abortion, Induced / Q000523:psychology*; D003657:Decision Making / Q000941:ethics*; D005260:Female; D006801:Humans; D010290:Parents / Q000523:psychology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000523:psychology*; D011296:Prenatal Diagnosis; D012729:Sex Chromosome Aberrations