• 作者：Sophie Chaulet ; Anne-Sophie Juan-Chocard ; St茅phanie Vasseur ; Jean-Fran莽ois Hamel ; Philippe Duverger ; Philippe Descamps ; Serge Fanello
• 关键词：Dé ; ni de grossesse ; É ; pidé ; miologie ; É ; valuation ; Pré ; vention
• 刊名：Annales medico-psychologiques
• 出版年：December, 2013
• 年：2013
• 卷：171
• 期：10
• 页码：705-709
• 全文大小：363 K

The denial of pregnancy is a vague and badly defined entity with no international consensus. Yet this phenomenon is often found by health professionals, provoking much questioning on its aetiology and how to treat it. The denial of pregnancy constitutes a potentially risky situation for both mother and child.

Objective

The objective of this study is to describe the medical, social and professional profiles, and the clinical characteristics of patients showing denial of pregnancy at the Maternity Hospital at Angers CHU. The short-term outcome for babies born from these pregnancies is described. The aim of the analyses is to improve the treatment and prevention of this syndrome.

Method

A retrospective analysis of epidemiological and clinical parameters from the medical records of women showing denial of pregnancy over a period of 5 years between 1 January 2005 and 31 December 2009.

Patients

In the CIM-10, no specific code for denial of pregnancy exists. Consequently, we looked for an existing code that could be adapted to cover such cases. A total of 392 files were extracted of which 75聽cases involved doctors discovering patients with an advanced pregnancy. We divided them into those discovered with less than, or greater than, 20聽weeks amenorrhoea. The 75聽pregnancies involved 76聽babies.

Results

The average frequency of denial of pregnancy over the five year period was 2.3/1000聽births for women with 20聽and 38聽weeks amenorrhoea. The frequency of total denial until birth was 0.3/1000聽births. The age of the women varied from 16 to 44聽years. The proportion of women in a socially precarious situation was more than 40%. Half of the women had had at least one child before, 9% of the women had shown a late discovery of pregnancy, and 20% had a history of a psychiatric problem. In 92% of cases the baby stayed with the Mother, in 8% the babies died before birth, in 3% the baby died after birth, and 4% were given up for adoption. There were significantly more abandonments among women who had shown a denial of pregnancy than in the general population. There were no significant differences in the epidemiological or clinical parameters between the pregnancies discovered between 15 and 19聽weeks amenorrhoea and those discovered after 20聽weeks amenorrhoea. Twenty-five percent of women had been for a psychological or psychiatric consultation although the consultation was rarely motivated by a denial of pregnancy.

Conclusions

The difficulties we had to identify a denial of pregnancy attest to the ignorance of this phenomenon and the difficulty of defining it precisely. The relevance of a previous psychiatric consultation is uncertain, as few studies on denial of pregnancy have been carried out. We propose that a psychological or psychiatric consultation should be offered to any woman having shown denial of pregnancy in order to provide the necessary support.