Portal de Periódicos da CAPES

Response to Pieters et al.

2012; Elsevier BV; Volume: 14; Issue: 5 Linguagem: Inglês

10.1038/gim.2012.33

1530-0366

Kwon Chan Jeon, Lei‐Shih Chen, Patricia Goodson,

Reproductive Health and Technologies

To the Editor: We wish to thank Pieters, Kooper, Smits, and Feuth for their interest in our review. We appreciate their thoughtful comments and the important factors raised in their letter “Considering Factors Affecting the Parental Decision to Abort After a Prenatal Diagnosis of a Sex Chromosome Abnormality”1.Pieters J.J.P.M. Kooper A.J.A. Smits A.P.T. Feuth T.B. Considering factors affecting the parental decision to abort after a prenatal diagnosis of a sex chromosome abnormality.10.1038/gim.2012.32Genet Med. 2012; 14: 558-559Google Scholar. Nonetheless, for the sake of clarity, we would like to point out that our review2.Jeon K.C. Chen L.S. Goodson P. Decision to abort after a prenatal diagnosis of sex chromosome abnormality: a systematic review of the literature.10.1038/gim.0b013e31822e57a7Genet Med. 2012; 14: 27-38Google Scholar extends beyond an analysis of demographic factors to include nondemographic variables such as type of sex chromosome abnormality and parents’ fears.No doubt the confounding factors raised by Pieters and colleagues (reason for referral, the role of the Internet, and qualifications of counseling providers) are extremely important for more fully understanding decisions to continue or terminate a sex chromosome abnormality–affected pregnancy. Unfortunately, these factors did not emerge as findings in the studies we reviewed, as they were not sufficiently explored in this body of work. Therefore, we thank Pieters and colleagues for helping to highlight and reinforce both this gap and our call for better-quality studies. To date, assessments of decisions surrounding a sex chromosome abnormality–affected pregnancy have been limited in their ability to identify the multiple factors shaping these decisions, the nuanced variability within those factors, and the complex interactions among them. Studies that (i) tap into the context of decision-making, (ii) examine how parents obtain information on their own through the Internet, and (iii) explore the role played by various types of service providers, in-depth—are urgently needed!Moreover, as we argue in our review, studies of better methodological quality are also missing from this body of literature. Given the multifactor nature of the topic, it makes little sense to capture complex associations among factors and decisions using descriptive or bivariate statistical analyses without controlling for confounders or covariates. Also missing from this literature are qualitative studies that portray parents’ points of view and voices, directly.Finally, given the below-average methodological quality scores of most studies in the review, we chose not to report each study’s score individually. These are available, however, upon request to the authors.DisclosureThe authors declare no conflict of interest. To the Editor: We wish to thank Pieters, Kooper, Smits, and Feuth for their interest in our review. We appreciate their thoughtful comments and the important factors raised in their letter “Considering Factors Affecting the Parental Decision to Abort After a Prenatal Diagnosis of a Sex Chromosome Abnormality”1.Pieters J.J.P.M. Kooper A.J.A. Smits A.P.T. Feuth T.B. Considering factors affecting the parental decision to abort after a prenatal diagnosis of a sex chromosome abnormality.10.1038/gim.2012.32Genet Med. 2012; 14: 558-559Google Scholar. Nonetheless, for the sake of clarity, we would like to point out that our review2.Jeon K.C. Chen L.S. Goodson P. Decision to abort after a prenatal diagnosis of sex chromosome abnormality: a systematic review of the literature.10.1038/gim.0b013e31822e57a7Genet Med. 2012; 14: 27-38Google Scholar extends beyond an analysis of demographic factors to include nondemographic variables such as type of sex chromosome abnormality and parents’ fears. No doubt the confounding factors raised by Pieters and colleagues (reason for referral, the role of the Internet, and qualifications of counseling providers) are extremely important for more fully understanding decisions to continue or terminate a sex chromosome abnormality–affected pregnancy. Unfortunately, these factors did not emerge as findings in the studies we reviewed, as they were not sufficiently explored in this body of work. Therefore, we thank Pieters and colleagues for helping to highlight and reinforce both this gap and our call for better-quality studies. To date, assessments of decisions surrounding a sex chromosome abnormality–affected pregnancy have been limited in their ability to identify the multiple factors shaping these decisions, the nuanced variability within those factors, and the complex interactions among them. Studies that (i) tap into the context of decision-making, (ii) examine how parents obtain information on their own through the Internet, and (iii) explore the role played by various types of service providers, in-depth—are urgently needed! Moreover, as we argue in our review, studies of better methodological quality are also missing from this body of literature. Given the multifactor nature of the topic, it makes little sense to capture complex associations among factors and decisions using descriptive or bivariate statistical analyses without controlling for confounders or covariates. Also missing from this literature are qualitative studies that portray parents’ points of view and voices, directly. Finally, given the below-average methodological quality scores of most studies in the review, we chose not to report each study’s score individually. These are available, however, upon request to the authors. DisclosureThe authors declare no conflict of interest. The authors declare no conflict of interest.