The impact of diagnosed fetal anomaly, diagnostic severity and prognostic ambiguity on parental depression and traumatic stress: a prospective longitudinal cohort study

Abstract

Introduction:The detection of a fetal anomaly during routine obstetric ultrasound is a potentially traumatic experience. The aim of this study is to examine longitudinally the impact of diagnosis of fetal anomaly on symptoms of depression and traumatic stress among mothers and fathers, and to examine how variations in psychological adjustment relate to diagnostic severity and prognostic ambiguity. Material and methods:In this prospective observational study conducted at a tertiary perinatal referral center, 81 mothers and 69 fathers with ultrasound findings of fetal anomaly completed the Edinburgh Postnatal Depression Scale (EPDS) and Impact of Events Scale (IES) at four time points in pregnancy (T1-T4) and 6 weeks after birth (T5).We compared this with depression and traumatic stress in a sample of non-affected parents (n = 110 mothers, 98 fathers).Results: Linear mixed effects models indicated that parents who received a diagnosis of fetal anomaly experienced higher levels of depression and traumatic stress over time, compared with non-affected parents. Depression: mean difference mothers = 4.46 ± 0.47, fathers = 2.80 ± 0.42. Traumatic stress: mean difference mothers = 20.04 ± 2.13, fathers = 12.66 ± 1.74. Parents with a more severe diagnosis experienced elevated symptoms compared with parents with a less severe diagnosis.Among mothers, prognostic ambiguity and changes in the anticipated diagnosis after birth were also associated with increased distress, regardless of whether the change was for the better or worse. Conclusions: Diagnosis of fetal anomaly increases risk of depression and traumaticstress in expectant mothers and fathers, both acutely and over time.

Effects of paediatric intensive care due to congenital heart defects on maternal mental health

“…As previously reported women within the PICU group had a significantly higher risk for postpartum depressive symptoms and an increased relative probability to develop an impaired mother child interaction. Our results further underline previous reports stating that diagnosis of foetal anomalies or disorders are associated with increased parental stress and postpartum depression 33,34 and that stress in the postpartum period along other factors is associated with depression 35 . In our data, the PICU group was at a higher risk to develop bonding problems on the total scale and particularly in the domains of rejection and pathological anger as well as infant‐focused anxiety which is in line with previous data reporting an association between postpartum depression and impaired bonding 36 .…”

Accuracy of prenatal detection of facial clefts and relation between facial clefts, additional malformations and chromosomal abnormalities: a large referral-center cohort

“…Accurate prenatal diagnosis is paramount because of the vast psychological consequences for the parents following of the diagnosis of a fetal anomaly [ 19 ]. In addition, and in the context of clefts, an accurate prediction of its type helps to tailor counselling of the parents for the postnatal management by the interdisciplinary team and especially the pediatric maxillofacial surgery team.…”

Harnessing the Power of Artificial Intelligence in Cleft Lip and Palate: An In-Depth Analysis from Diagnosis to Treatment, a Comprehensive Review

“…Prenatal diagnosis of orofacial clefts has traditionally relied on physical examination and visual inspection of the oral cavity. However, prenatal ultrasound scans, typically performed around the 20th week of gestation, provide more accurate and comprehensive diagnostic information, enabling healthcare providers to counsel parents and make in-formed decisions about pregnancy [58,59]. Healthcare providers must strive to provide the most precise and comprehensive diagnostic information possible; this can help mitigate the parents' emotional distress and facilitate informed decision-making regarding the best course of action for the pregnancy [58].…”