Results
A total of 398 pregnant women visited our hospital between May 2022 and March 2023. Among them, 273 had a birth outcome (delivery or termination of pregnancy). However, three participants did not answer the phone during the telephone follow-up and five refused to participate in the study. Ultimately, 265 pregnant women were included in this study. A total of 190 pregnant women gave birth either through natural labor ( n = 91) or cesarean section ( n = 99); however, six newborns died within 1 month of birth. Of the remaining 75 pregnant women with fetal abnormalities, 67 chose to induce labor, and eight pregnant women with twin pregnancies opted for fetal reduction. In addition, the average age of the pregnant women was 30.05 ± 4.60 years (range, 20–47 years), with 257 singleton pregnancies and eight twin pregnancies. The gestational age at diagnosis of fetal abnormalities was ≤13 +6 weeks in 5 case (1.9%), 14–27 +6 weeks in 183 case (69.1%), and ≥28 weeks in 77 cases (29%). 36 pregnant women were advised to carefully consider whether to continue with the termination, and 229 pregnant women were advised to continue with pregnancy follow-up ( Table 1 ).

In our study, there were 211 cases of single fetal abnormalities and 54 cases of multiple fetal abnormalities. For improved statistical classification, all instances of abnormal fetal diagnoses were calculated based on their frequency and occurrence rate. A total of 330 cases with fetal abnormalities were diagnosed, including 60 cases (18.2%) with central nervous system abnormalities, 52 cases (15.8%) with cardiovascular system abnormalities, 53 cases (16.10%) with respiratory system dysplasia, 54 cases (16.4%) with urinary system dysplasia, 37 cases (11.2%) with digestive system dysplasia, 23 cases (7.0%) with musculoskeletal system dysplasia, 19 cases (5.8%) with facial dysplasia, and six cases (1.8%) with gene/chromosome abnormalities. There were 16 cases (4.8%) of fetal tumors, three cases (0.9%) of anterior abdominal wall dysplasia, three cases (0.9%) of fetal hydrops, two cases (0.6%) of reproductive system dysplasia, and two cases (0.6%) of viral infection ( Figure 1 ). The most common fetal abnormalities diagnosed in pregnant women include abnormalities in the central nervous, urinary, cardiovascular, and respiratory systems. The two primary abnormalities that resulted in TOP were also related to central nervous and cardiovascular system abnormalities ( Figure 2 ).

Chi-square test analysis showed significant differences in the gestational age at diagnosis of fetal abnormalities, the number of fetal abnormalities, diagnostic gestational age, and treatment recommendations of doctors among pregnant women ( P < 0.05). However, there were no significant differences in maternal age, number of births, abortion history, history of fetal abnormalities, mode of conception, pregnancy complications, education level, employment status, or place of abode ( Table 1 ).

We conducted binary logistic regression analysis using gestational age (first, second, or third trimester), number of organs affected by fetal abnormalities (single abnormality/multiple abnormalities), and treatment recommendations. The gestational age at diagnosis, number of fetal abnormalities, and diagnosis and treatment recommendations of doctors showed statistically significant differences in pregnancy outcomes. Based on the literature ( Crowe et al., 2018 ; Michalik & Preis, 2014 ) and clinical experience, maternal age, number of births, abortion history, history of fetal abnormalities, mode of conception, pregnancy complications, and educational level may be potential confounding factors affecting pregnancy outcomes. Therefore, to enhance the accuracy of the statistical results, we adjusted for the confounding factors. Consequently, we discovered that diagnostic gestational age did not have a significant impact on pregnancy outcomes ( P > 0.05). The treatment recommendations of doctors, as well as the number of fetal abnormalities, significantly affected pregnancy outcomes in pregnant women ( P < 0.05).

Pregnant women with multiple fetal abnormalities were 3.774 times more likely to undergo labor induction than those with a single fetal abnormality (OR = 3.774, 95% CI [1.640–8.683]). Pregnant women who were advised to terminate their pregnancies or carefully consider whether to continue gestation were 41.113 times more likely to undergo labor induction compared to those who were advised to continue the pregnancy (OR = 41.113, 95% CI [11.028–153.267]), ( Table 2 ).

Notes:

The variables adjusted for were gestational age, number of births, history of abortion, history of fetal abnormalities, mode of conception, complication of pregnancy, degree of education.