Prenatal diagnosis of birth defects and termination of pregnancy in Hunan Province, China.

To analyse the characteristics of the prenatal diagnosis (PD) of birth defects(BDs) and termination of pregnancy (TOP) for foetal anomalies and to suggest perinatal management.Birth defects surveillance data were collected from 52 registered hospitals in Hunan between 2015 and 2018. The PD and TOP rates of BDs were calculated to examine the associations between infant sex, maternal age, and region .From 2015 to 2018, a total of 18931 foetuses with BDs were identified, of which 10299 foetuses (54.4%) were diagnosed prenatally and 9343 pregnancies (90.7% among PDs, 49.3% among BDs) were terminated. The mean gestational age at diagnosis for fetuses with BDs was 25.1±5.9 weeks and showed a downward trend over the study period. The average PD rate of the BDs was higher in rural areas than in urban areas (58.1% vs 50.3%), higher for female than male foetuses (57.25% vs 48.92%), and higher for mothers older than age 35 than for those younger (58.62% vs 53.69%). The average TOP rate of foetuses with BDs in rural areas was higher than that in urban areas (91.99% vs 89.12%) and decreased with increasing maternal age (x trend=7.926, P=0.005). The five BDs with the highest PD rates were conjoined twins (100%), anencephaly (97.87%), congenital hydrocephalus (97.66%), chromosomal malformation (96.07%), and encephalocele (95.54%). The five BDs with the highest TOP rates among the PDs were conjoined twins (100%), exstrophy of the urinary bladder (100%), chromosomal malformation (98.09%), encephalocele (98%), and anencephaly (97.28%).More than half of BDs were diagnosed prenatally, with the majority diagnosed at less than 28 gestational weeks. The TOP rates following PD in Hunan Province were high, especially for rural and younger mothers. The findings suggest a need for high-quality, targeted counselling following PD. This article is protected by copyright. All rights reserved.