title: Prenatal diagnosis of haemophilia in Sweden now more commonly used for psychological preparation than termination of pregnancy.
abstract: The aims of the study were to define the frequency, outcome and reasons for prenatal diagnosis (PND) in Sweden during a 30-year period in order to study trends and changes. The study population, from the Swedish nationwide registry of PND of haemophilia, consisted of 54 women, compromising >95% of all, who underwent PND (n = 90) of haemophilia during 1977-2013. PND was performed by amniocentesis (n = 10), chorionic villus sampling (n = 64) or by analysis of foetal blood (n = 16). A total of 27/90 foetuses were found to have haemophilia. Sixteen went to termination and the remaining 11 were born during the end of the study period (2000-2013). Three of 90 pregnancies were terminated due to findings other than haemophilia and 3/90 PNDs led to miscarriage. In the 30 families with known haemophilia, PNDs (n = 55) were used in 27/55 cases for 'psychological preparation' and in 23/55 cases with the aim to terminate the pregnancy. A subgroup of women (n = 17) who consecutively underwent PND in the years 1997-2010 were further interviewed. For 11/17, being a carrier had a negative effect on the decision to become pregnant, and in 11 cases PND had influenced their decision to conceive. Our study show that PND of haemophilia is stable over time but increasingly used during the last decade as a psychological preparation for having a child with haemophilia as compared to earlier where more terminations of pregnancies were conducted.
authors.affiliation: Department of Clinical Sciences Malmö, Lund University, Sweden; Department of Paediatrics and Malmö Centre for Thrombosis and Haemostasis, Skåne University Hospital, Lund University, Malmö, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Mårtensson
authors.forename: U
authors.initials: U
authors.lastname: Tedgård
authors.forename: R
authors.initials: R
authors.lastname: Ljung
mesh_terms: D000032:Abortion, Therapeutic; D000328:Adult; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D006467:Hemophilia A / Q000175:diagnosis* / Q000453:epidemiology; D002836:Hemophilia B / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D011788:Quality of Life; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: carrier; factor IX; factor VIII; haemophilia A; haemophilia B; prenatal diagnosis