{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:29:32Z","timestamp":1753892972428,"version":"3.41.2"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study explores the attitudes of Chinese maternal and child health professionals toward the termination of pregnancy for fetal anomaly (TOPFA) based on four case scenarios and further identifies the factors that influence their attitudes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study, conducted from February 14\u201321, 2022, aimed to explore the attitudes of maternal and child health professionals toward TOPFA in Hunan Province. We targeted health service institutions across 14 prefecture-level cities and the autonomous prefecture. A questionnaire was made available online and shared via the instant communication platform, WeChat. Participants were recruited through the same platform and completed the survey online. Descriptive statistics were used to analyze the data, and binary logistic regression was performed to determine factors affecting the health professionals\u2019 attitudes toward TOPFA, expressed as the odds ratio (OR) and 95% confidence intervals (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study found that 63.5% of health professionals approved of the birth of a fetus with cleft lip and palate, while 36.5% opposed it. Similarly, 39.7% approved of the birth of a fetus with phenylketonuria, while 60.3% opposed it. The percentages of those in favor of and against the birth of a fetus with precocious heart disease were 45.5 and 54.5%, respectively, and those for and against the birth of a fetus with missing fingers were 50.8 and 49.2%, respectively. The top three factors considered by health professionals when agreeing on TOPFA were \u201cthe impact of fetal disease on fetal function and growth,\u201d \u201cthe severity of fetal disease,\u201d and \u201cthe assessment of indications for fetal disease by professionals and related professional advice.\u201d The majority of health professionals (75\u201378%) preferred joint decision-making by parents regarding the right to decide TOPFA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study indicates that the attitudes of health professionals toward TOPFA can differ significantly depending on the specific birth defect under consideration. Notably, the majority of health professionals prioritized \u201cthe impact of fetal abnormalities on fetal function and development\u201d when deciding their support for TOPFA, advocating for the decision to be a joint one between the parents. Additionally, factors such as religious beliefs, professional training, age, and job title appeared to influence these attitudes toward TOPFA. Our findings could serve as a reference point in the development of guidelines for the prevention and management of birth defects.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1189266","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T19:22:17Z","timestamp":1694114537000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Attitudes of Chinese maternal and child health professionals toward termination of pregnancy for fetal anomaly: a cross-sectional survey"],"prefix":"10.3389","volume":"11","author":[{"given":"Ying","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanlin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuqiong","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"212874","DOI":"10.1155\/2014\/212874","article-title":"Birth 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consequences","volume":"73","author":"Guillaume","year":"2018","journal-title":"Population"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1186\/s12889-021-11653-4","article-title":"Repeat abortion and associated factors among women seeking abortion services in northwestern China: a cross-sectional study","volume":"21","author":"Li","year":"2021","journal-title":"BMC Public Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1111\/j.1471-0528.2008.01700.x","article-title":"Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down's syndrome","volume":"115","author":"Boyd","year":"2008","journal-title":"BJOG"},{"year":"2021","key":"ref15"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1363\/46e0920","article-title":"Global developments in laws on induced abortion: 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