Attitudes of Chinese health professionals toward termination of pregnancy for fetal anomaly: a cross-sectional survey

Abstract

Background:This cross-sectional study explores the attitudes of Chinese health professionals toward the termination of pregnancy for fetal anomaly (TOPFA) based on four case scenarios. The study aims to identify the factors that influence their attitudes and provide insights to formulate norms and strategies for prevention and treatment of fetal anomalies. Methods: A convenience sampling method was employed, and 750 valid questionnaires were collected from 14 prefectures and cities in central China. Descriptive statistics were used to analyze the data, and binary logistic regression was used to determine associations between health professionals’ attitudes toward TOPFA and sociodemographic and other variables, expressed as the odds ratio (OR) and 95% confidence intervals (CI). Results: 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 that influenced the attitudes of health professionals toward the birth of a defective fetus were "the impact of the fetus' own disease on its physical function and growth," "the severity of the fetus' own disease," and "the professional assessment of the indications for treatment of the fetus' disease and related professional advice." The majority of health professionals (75–78%) preferred joint decision-making by parents regarding the right to decide whether a fetus with birth defects will be born. Conclusions:This study is the first case-based study in China to examine the attitudes of Chinese health professionals toward TOPFA. It highlights the need for professional training including in ethics and medical strategies related to birth defects prevention and control for health professionals at all levels. The findings of this study provide valuable insights for formulating norms and strategies for the prevention and treatment of fetal anomalies in China.