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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Available from: Suzanne Levy, Nov 24, 2015
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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.
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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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    • "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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