Outcomes of pregnancies diagnosed with Klinefelter syndrome: The possible influence of health professionals

Objective: To describe the association between the outcomes of pregnancies diagnosed with Klinefelter syndrome (KS) and the speciality of the health professional providing pre- and post-diagnostic counselling. Method: Data were extracted from the case notes of the 111 cases of KS diagnosed prenatally between 1986 and 1997 in eight geographical regions in five European countries. The data extracted included: outcome of pregnancy, maternal age, social class, parity, gestational age at diagnosis, year of diagnosis and specialities of the health professionals conducting pre- and post-diagnosis consultations. Results: The overall termination rate was 44% (49/111: 95% confidence interval: 35 to 54). Using multivariable logistic regression analysis, the only significant predictor of continuation of the pregnancy was the specialities of the health professionals conducting post- diagnosis counselling: the affected pregnancy was more likely to continue when post-diagnosis counselling involved only a genetics specialist (relative risk: 2.42 (1.14 to 5.92)). Conclusion: There is an association between whether or not a woman terminates a pregnancy affected by an unfamiliar fetal anomaly and the professional background of the health professional providing postdiagnostic counselling. The causal nature of this association remains to be determined.