Maternal Psychological Stress after Prenatal Diagnosis of Congenital Heart Disease

Fetal Heart Program at the Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, PA
The Journal of pediatrics (Impact Factor: 3.79). 09/2012; 162(2). DOI: 10.1016/j.jpeds.2012.07.023
Source: PubMed


To determine whether prenatal diagnosis of congenital heart disease (CHD) increases maternal stress.

Study design:
Self-report instruments were administered to mothers carrying a fetus with CHD. Domains included: (1) traumatic stress (Impact of Events Scale-Revised); (2) depression (Beck Depression Index II); and (3) anxiety (State-Trait Anxiety Index). Modifiers included: (1) coping skills (COPE Inventory); (2) partner satisfaction (Dyadic Adjustment Scale); and (3) demographics. Multivariate linear regression models were used to assess relationships between stress measures and modifiers.

Fifty-nine mothers (gestational age 27 ± 3 weeks) completed all measures. Clinically important traumatic distress was seen in 39%, depression in 22%, and state anxiety in 31%. Lower partner satisfaction was associated with higher depression (P < .01) and higher anxiety (P < .01). After controlling for partner satisfaction and income, "denial" was most associated with increased traumatic stress, anxiety, and depression (P < .01).

Posttraumatic stress, depression, and anxiety are common after prenatal diagnosis of CHD. Healthy partner relationships and positive coping mechanisms can act as buffers.

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    • "Infant health and survival are directly related to the quality and continuity of care, and studies indicate the buffering (neutralizing) role of mothers in terms of problems arising from infants’ diseases and chronic disorders.[41] Thus, regarding the importance of the issue and prematurity-caused complications in these infants, designing special programs focusing on supporting this group of mothers seems to be essential. "
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    ABSTRACT: Background: In recent years, there has been a rise in the number of premature births. Mothers of these newborns experience a high degree of stress over time. Since a more comprehensive understanding of this phenomenon can help the healthcare teams in detecting the deficiencies and needs of such newborns’ mothers for a better and more effective intervention, the present study was carried out to describe the mothers’ experiences in the area of premature birth. Materials and Methods: The present study is a qualitative study with a content analysis approach. The data collection process included 15 semi-structured and in-depth interviews with the mothers delivering premature babies during 2012-2013 in the medical educational centers of north and northwest of Iran. A purposive sampling method was used. All the interviews were recorded, typed, and finally analyzed using a qualitative content analysis with a conventional method. Results: Data analysis led to the extraction of continuous and multiple waves of emotional responses in mothers with premature birth. This has been revealed in mothers by the different categories of affective reactions, symptoms of anxiety, and mood disturbances including decline in performance, individual shortcomings, and mental irritation. Conclusions: Mothers’ unpreparedness and unexpected childbirth make them encounter the multiple and continuous waves of emotional responses, which will consequently lead to decline in performance, individual shortcomings, and mental irritation among them. Therefore, in order to prevent the negative and long-term consequences of such reactions, it is recommended that more attention should be given to support these mothers as the main caregivers of such infants.
    Iranian journal of nursing and midwifery research 07/2014; 19(4):340-8.
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    • "Factorial invariance across gender has been reported (South et al., 2009), although not in the Spanish population. Within the past year, the DAS has been used to measure dyadic satisfaction in many different medical disciplines such as cardiology (Rychik et al., 2013), neurology (Norup & Elklit, 2013), obstetrics and gynaecology (Galhardo, Cunha, Pinto-Gouveia, & Matos, 2013; Van den Broeck et al., 2013), oncology (Fife, Weaver, Cook, & Stump, 2013; Robbins, Mehl, Smith, & Weihs, 2013), otorhinolaryngology (Smith, Pukall, & Chamberlain, 2013), urology (Walker, Hampton, Wassersug, Thomas, & Robinson, 2013), or psychology (Daspe, Sabourin, Péloquin, Lussier, & Wright, 2013; Varghese et al., 2013). The DAS has been adapted for use in many countries. "
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    ABSTRACT: La Escala de Ajuste Diádico (EAD) es una escala de autoinforme de satisfacción conyugal que ha sido ampliamente utilizada en distintas culturas. En España no existen en la actualidad estudios que analicen las propiedades psicométricas de la escala en parejas con y sin malestar ni que realicen análisis factoriales independientes de los datos de hombres y mujeres. El objetivo de este estudio es determinar algunas propiedades psicométricas de una versión española de la EAD en una muestra de 915 participantes: 403 que buscaban terapia de pareja y 512 que no requerían terapia. Los resultados respaldan la fiabilidad del instrumento para ambas submuestras. El análisis factorial confirmatorio mostró una estructura interna de cuatro factores que se corresponde con la propuesta por el autor de la escala original. Además, la versión española de la EAD ofrece una alta capacidad discriminante entre ambos subgrupos, constituyendo un instrumento válido y fiable para medir la satisfacción conyugal en parejas españolas que buscan terapia y en aquellas que no la requieren.
    International Journal of Clinical and Health Psychology 05/2014; 14(2):137–144. DOI:10.1016/S1697-2600(14)70047-X · 2.79 Impact Factor
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    • "Another cross-sectional study showed that several pregnancy and non-pregnancy related events were associated with emotional and somatic distress but in the analyses no distinction between the two types of events was made (Traviss et al., 2012). In line with our finding is that an antenatal diagnosis of congenital heart disease was associated more with anxiety than with depression (Rychik et al., 2012). Kowalcek et al. (2003) found that women had higher anxiety levels both before and after antenatal testing, especially when they had a positive test result. "
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    ABSTRACT: to investigate the association of life events during pregnancy with change in antenatal anxiety and depression symptoms. We distinguished pregnancy related and non-pregnancy related events and assessed specificity of these associations for depressive or anxious symptoms. In addition, we investigated whether the associations were affected by personality or childhood adversities. observational prospective cohort study SETTING: primary and secondary obstetric care centres in the Netherlands PARTICIPANTS: 1603 women during their first trimester of pregnancy between May 2010 and May 2012 MEASUREMENTS AND FINDINGS: we performed linear regression analyses to test the associations of pregnancy related, non-pregnancy related life events, childhood adversities and the personality traits neuroticism and extraversion with the change in symptoms of anxiety (State Trait Anxiety Inventory) and depression (Edinburgh Postnatal Depression Scale) from week 12 to week 36. Life events during pregnancy were associated with increasing antenatal symptoms of anxiety and depression. Effect sizes associated with the highest numbers of events observed ranged from 0.59 to 1.31. Pregnancy related events were specifically associated with increasing symptoms of anxiety (p=0.009), whereas non-pregnancy related events were merely associated with an increase in symptoms of depression (p<0.001). Neither personality traits nor childhood trauma influenced the associations under study. the most important finding is that pregnancy related life events during pregnancy increase levels of antenatal anxiety, whereas depression levels increase when women experience life events that are unrelated to pregnancy. Furthermore, non-pregnancy related events show stronger associations with increases in symptoms of anxiety or depression compared to pregnancy related events. our findings may help midwives to tailor psychosocial care to the specific risks of the pregnant woman which may eventually have a positive impact on the health of mother and child.
    Midwifery 07/2013; 30(5). DOI:10.1016/j.midw.2013.06.008 · 1.57 Impact Factor
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