Down Syndrome is the Leading Indication for Late-stage Termination of Pregnancy in Mongolia

JOURNAL TITLE: Newborn

Author
1. Akhil Maheshwari
2. Gunjana Kumar
3. Srijan Singh
4. Jargalsaikhan Badarch
5. Alvaro Dendi
6. Tegshjargal Sereenendorj
7. Batbayar Tumurkhuleg
8. Budzaya Enkhbayar
9. Terkhen Turbat
10. On behalf of the Global Newborn Society (GNS) Down Syndrome Foundation
11. Amita Singhal
ISSN
DOI
10.5005/jp-journals-11002-0099
Volume
3
Issue
3
Publishing Year
2024
Pages
10
Author Affiliations
    1. Department of Obstetrics and Gynecology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; Mongolian Association of Obstetrics, Gynecology and Neonatology- MOGNA, Ulaanbaatar, Mongolia; Global Newborn Society, Clarksville, Maryland, United States of America; Mongolian Chapter of the Global Newborn Society, Ulaanbaatar, Mongolia
    1. Department of Neonatology, National Institute of Medical Sciences, Jaipur, Rajasthan, India
    1. RMC Clinic, Ulaanbaatar, Mongolia
    1. Department of Obstetrics and Gynecology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
    1. Enkh-Saruul “A” Clinic, Ulaanbaatar, Mongolia
    1. Khuree Maternity Hospital, Ulaanbaatar, Mongolia
    1. GNS Down Syndrome Foundation, Delhi, India
  • Article keywords
    Birth defect, Chromosomal anomalies, Cleft lip, Cleft palate, Combined defect, Congenital anomalies, Down syndrome, European surveillance of congenital anomalies, International classification of diseases, Termination of pregnancy for fetal anomaly

    Abstract

    Background: Prenatal sonograms frequently show congenital anomalies in fetuses. As expected, families receiving information about severe or multi-system anomalies experience ceaseless distress and may request for termination of the pregnancy. This study was designed to identify the most frequent indications for termination of pregnancy for fetal anomalies (TOPFAs). These data can help in early detection, which can then facilitate informed decisions either for safe terminations or for well-timed fetal procedures for rehabilitation. This information is also important for appropriate genetic testing and assessment of the risk of recurrence in later pregnancies. Objective: To investigate the frequency and epidemiological profile of various fetal abnormalities that have evoked requests for late termination of pregnancy in Mongolia. Materials and methods: This cross-sectional observational study was conducted in a cohort of 45,095 pregnancies. Of these, 156 were terminated because of fetal anomalies. Data pertaining to fetal/congenital anomalies were collected after informed consent from families and compared with 312 healthy controls to evaluate associated maternal risk factors. Results: In this cohort, 34.5 in 10,000 pregnancies were terminated because of fetal anomalies during the study period 2017–2019. A total of 156 terminations were related to congenital anomalies. Down syndrome (DS) was the most frequent reason (25%). The other leading reasons were multiple congenital anomalies (16%), cleft lip/palate (10.9%), and anomalies of the central nervous system (9.6%) or the musculoskeletal system (9.6%). Maternal age >35 years, higher education, less spacing between successive pregnancies, and previous history of abortion(s) were associated with a higher likelihood of birth defects. Conclusion: Down syndrome is the leading indication for late-stage TOPFAs in Mongolia. Multi-system congenital anomalies, clefts, and anomalies of the central nervous system and musculoskeletal system were other reasons that led to requests for termination of pregnancy.

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