Maternal psychological responses during pregnancy after ultrasonographic detection of structural fetal anomalies: A prospective longitudinal observational study

Abstract

In this longitudinal prospective observational study performed at a tertiary perinatal referral centre, we aimed to assess maternal distress in pregnancy in women with ultrasound findings of fetal anomaly and compare this with distress in pregnant women with normal ultrasound findings. Pregnant women with a structural fetal anomaly (n = 48) and normal ultrasound (n = 105) were included. We administered self-report questionnaires (General Health Questionnaire-28, Impact of Event Scale-22 [IES], and Edinburgh Postnatal Depression Scale) a few days following ultrasound detection of a fetal anomaly or a normal ultrasound (T1), 3 weeks post-ultrasound (T2), and at 30 (T3) and 36 weeks gestation (T4). Social dysfunction, health perception, and psychological distress (intrusion, avoidance, arousal, anxiety, and depression) were the main outcome measures. The median gestational age at T1 was 20 and 19 weeks in the group with and without fetal anomaly, respectively. In the fetal anomaly group, all psychological distress scores were highest at T1. In the group with a normal scan, distress scores were stable throughout pregnancy. At all assessments, the fetal anomaly group scored significantly higher (especially on depression-related questions) compared to the normal scan group, except on the IES Intrusion and Arousal subscales at T4, although with large individual differences. In conclusion, women with a known fetal anomaly initially had high stress scores, which gradually decreased, resembling those in women with a normal pregnancy. Psychological stress levels were stable and low during the latter half of gestation in women with a normal pregnancy.

Paternal Psychological Stress After Detection of Fetal Anomaly During Pregnancy. A Prospective Longitudinal Observational Study

“…However, the predicted future severity of an anomaly detected in utero may vary throughout pregnancy as new diagnostic information could possibly be added to previous information. In previous research, we have, however, found that psychological distress in expectant mothers decreased from the time the fetal anomaly was diagnosed, to gestational week 36 (Kaasen et al, 2017).…”

Mental health nursing and the prenatal diagnosis of a congenital anomaly; a narrative of experience

“…Two prospective single-centre studies assessed maternal anxiety using standardized assessments at various points after the diagnosis of a congenital anomaly and found state anxiety was the highest at the time of diagnosis (Aite et al, 2009;Kaasen et al, 2017). Within their longitudinal study, Kaasen et al (2017) reported the average score for the 48 participants reduced over the four-time points, although some women continued to meet the clinical threshold for anxiety at the final assessment at 36 weeks. Aite et al (2009) measured anxiety before and after consultation within two groups of pregnant women who had received prenatal diagnoses of lung malformations with a good prognosis (n = 21) or a life-threatening prognosis (n = 23).…”

Enfermagem no contexto familiar na prevenção de anomalias congênitas: revisão integrativa

“…As mães padecem de um alto nível de sofrimento psicológico materno, após a detecção de uma anomalia fetal. Esse sofrimento pode diminuir durante a gravidez, de um nível inicial alto para um nível quase normal, porém os sintomas de depressão podem estar presentes até o final da gravidez 35 .…”