Maternal risks and predictor factors for the termination of pregnancy in fetuses with severe congenital anomaly: experience from a single reference center in Brazil

Abstract

Objective: To assess the maternal complications in pregnant women with fetuses with several congenital anomaly as well as the predictor variables for the termination of pregnancy.Methods: We performed a retrospective cohort study with 94 medical records of pregnant women with fetal infeasibility confirmed in the postnatal period by clinical, radiological or anatomopathological exams. To compare the categorical variables regarding the termination and nontermination of pregnancy, we used analysis of variance (ANOVA) and the Mann–Whitney U-test. To assess the variables that were more associated with the judicial request for the termination of pregnancy, we used logistic regression.Results: The termination of pregnancy was performed in 41 (43.6%) and nontermination of pregnancy in 53 (56.4%) pregnant women. Pregnant women who did not terminate the pregnancy had more complications in the gestational period (p < 0.0001) and in the postpartum period (p = 0.0088). After multiple logistic regressions, the following variables influenced the decision to terminate the pregnancy: type of congenital anomaly (OR: 18.59; 95%CI: 1.96; 175.87) and living children (OR: 0.45; 95%CI: 0.25; 0.80).Conclusion: Most of the pregnant women with fetal infeasibility opted for nontermination of pregnancy and these patients had more obstetrical complications. The type of congenital anomaly and living children were the factors most associated with the choice for the termination of pregnancy.