{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T08:27:51Z","timestamp":1787128071290,"version":"build-2736575974"},"reference-count":21,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Termination of pregnancy (TOP) following a prenatal diagnosis of congenital heart disease (CHD) is a complex decision shaped by clinical, ethical, and psychosocial factors. This study evaluated the clinical factors associated with parental acceptance of TOP after prenatal diagnosis of CHD in a multidisciplinary counselling setting. Methods: This retrospective cohort study was conducted at a tertiary referral center where fetal CHD cases are evaluated in a multidisciplinary perinatology council. Pregnancies with a prenatal CHD diagnosis for which TOP was medically recommended between December 2023 and February 2026 were included. Maternal, fetal, and genetic data were analyzed. Cardiac severity was classified using the fetal cardiovascular disease severity scale. Because the cohort included only 62 pregnancies, a simplified multivariable logistic regression model with three clinically prespecified variables (four parameters: gestational age, cardiac severity, and genetic-evaluation status) was used to identify variables associated with termination acceptance. Results: Sixty-two pregnancies were included; 41 (66.1%) accepted termination and 21 (33.9%) continued the pregnancy. Maternal characteristics and gestational age at diagnosis were similar between groups. In the multivariable model, genetic-evaluation status was the only variable independently associated with termination acceptance. Compared with cases without genetic testing, both major chromosomal\/pathogenic anomalies (aOR 4.97; 95% CI 1.29\u201319.11; p = 0.020) and a normal genetic-evaluation status (aOR 4.71; 95% CI 1.07\u201320.77; p = 0.041) were associated with higher termination acceptance. Cardiac severity and gestational age were not independently associated with parental decision. Conclusions: Genetic-evaluation status was associated with parental acceptance of termination after prenatal CHD diagnosis in a multidisciplinary counselling setting; given the small sample size and the selected, council-recommended cohort studied, this association should be interpreted as hypothesis-generating rather than as evidence of a causal or independent predictive effect.<\/jats:p>","DOI":"10.3390\/diagnostics16162624","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T07:58:23Z","timestamp":1787126303000},"page":"2624","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Parental\u00a0Decision-Making Process in Termination of Pregnancy for Congenital Heart Disease: From the Multidisciplinary Perinatal Council of a Turkish Tertiary Center"],"prefix":"10.3390","volume":"16","author":[{"given":"Abdulmecit","family":"Oktem","sequence":"first","affiliation":[{"name":"Department of Perinatology, Izmir City Hospital, Izmir 35540, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3662-8740","authenticated-orcid":false,"given":"Mukremin","family":"Ceylan","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Izmir City Hospital, Izmir 35540, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8682-5537","authenticated-orcid":false,"given":"Hakan","family":"Golbasi","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Izmir City Hospital, Izmir 35540, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Blakeley, C., Smith, D.M., Johnstone, E.D., and Wittkowski, A. (2019). Parental decision-making following a prenatal diagnosis that is lethal, life-limiting, or has long term implications for the future child and family: A meta-synthesis of qualitative literature. BMC Med. Ethics, 20.","DOI":"10.1186\/s12910-019-0393-7"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1002\/pd.2923","article-title":"Fetal heart disease and interruption of pregnancy: Factors influencing the parental decision-making process","volume":"32","author":"Chenni","year":"2012","journal-title":"Prenat. Diagn."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1002\/pd.5480","article-title":"Fetal cardiac abnormalities: Genetic etiologies to be considered","volume":"39","author":"Petracchi","year":"2019","journal-title":"Prenat. Diagn."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S369","DOI":"10.21037\/cdt.2019.07.07","article-title":"Current research status on the psychological situation of parents of children with congenital heart disease","volume":"9","author":"Biber","year":"2019","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e004862","DOI":"10.1161\/JAHA.116.004862","article-title":"Mental Health Among Parents of Children With Critical Congenital Heart Defects: A Systematic Review","volume":"6","author":"Anger","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1111\/hex.12664","article-title":"Diagnosis of a severe congenital anomaly: A qualitative analysis of parental decision making and the implications for healthcare encounters","volume":"21","author":"Lotto","year":"2018","journal-title":"Health Expect."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1007\/s10815-024-03112-x","article-title":"Decision-making for congenital anomalies diagnosed during pregnancy: A narrative review","volume":"41","author":"Pecoriello","year":"2024","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"100207","DOI":"10.1016\/j.ajogmf.2020.100207","article-title":"Prenatal diagnosis of congenital heart defects and voluntary termination of pregnancy","volume":"2","author":"Montaguti","year":"2020","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"7564","DOI":"10.1038\/s41598-020-64591-3","article-title":"Prenatal diagnosis and pregnancy outcomes of 1492 fetuses with congenital heart disease: Role of multidisciplinary-joint consultation in prenatal diagnosis","volume":"10","author":"Qiu","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1002\/pd.6706","article-title":"Evaluating How Beliefs Among Pediatric Cardiology Providers May Affect Fetal Cardiac Counseling-A National Perspective","volume":"45","author":"Haxel","year":"2025","journal-title":"Prenat. Diagn."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kovacevic, A., B\u00e4r, S., Starystach, S., Simmelbauer, A., Els\u00e4sser, M., M\u00fcller, A., Motlagh, A.M., Oberhoffer-Fritz, R., Ostermayer, E., and Ewert, P. (2020). Objective Assessment of Counselling for Fetal Heart Defects: An Interdisciplinary Multicenter Study. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020467"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e-rbgoedt1","DOI":"10.61622\/rbgo\/2025EDT01","article-title":"Family counseling after prenatal diagnosis of congenital heart disease: The role of a multidisciplinary and humanized approach","volume":"47","author":"Amorim","year":"2025","journal-title":"Rev. Bras. Ginecol. Obstet."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1007\/s00246-014-0911-9","article-title":"Development and Validation of a Fetal Cardiovascular Disease Severity Scale","volume":"35","author":"Davey","year":"2014","journal-title":"Pediatr. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1007\/s00246-009-9514-2","article-title":"Chromosomal Anomalies Influence Parental Treatment Decisions in Relation to Prenatally Diagnosed Congenital Heart Disease","volume":"30","author":"Zyblewski","year":"2009","journal-title":"Pediatr. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.pedneo.2022.07.015","article-title":"Associated factors with parental pregnancy decision-making and use of consultation after a prenatal congenital heart disease diagnosis","volume":"64","author":"Chih","year":"2023","journal-title":"Pediatr. Neonatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1002\/pd.6078","article-title":"Pregnancy outcomes of fetuses with congenital heart disease after a prenatal diagnosis with chromosome microarray","volume":"42","author":"Zhang","year":"2022","journal-title":"Prenat. Diagn."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.acvd.2016.01.006","article-title":"Associated genetic syndromes and extracardiac malformations strongly influence outcomes of fetuses with congenital heart diseases","volume":"109","author":"Bensemlali","year":"2016","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"15055","DOI":"10.1038\/s41598-024-66027-8","article-title":"Association between parental decisions regarding abortion and severity of fetal heart disease","volume":"14","author":"Nakao","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3923","DOI":"10.1038\/s41598-025-88570-8","article-title":"Chromosomal analysis and short-term outcome of prenatally diagnosed congenital heart disease","volume":"15","author":"Verbeke","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1002\/uog.24863","article-title":"Impact of maternal social vulnerability and timing of prenatal care on outcome of prenatally detected congenital heart disease","volume":"60","author":"Perez","year":"2022","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"lsad023","DOI":"10.1093\/jlb\/lsad023","article-title":"The right to terminate pregnancy (abortion): Reflections from Turkey","volume":"10","year":"2023","journal-title":"J. Law Biosci."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/16\/2624\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T08:11:40Z","timestamp":1787127100000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/16\/2624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":21,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["diagnostics16162624"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16162624","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]}}}