Maternal Psychological Stress after Prenatal Diagnosis of Congenital Heart Disease

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• 作者：Jack Rychik ; MD¹ ; ⁴ ; ^{Rychik@email.chop.edu} ; Denise D. Donaghue ; RN ; MSN¹ ; Suzanne Levy ; PhD² ; ⁵ ; Clara Fajardo ; MS² ; Jill Combs ; RN ; MSN¹ ; Xuemei Zhang ; MS³ ; Anita Szwast ; MD¹ ; ⁴ ; Guy S. Diamond ; PhD² ; ⁵
• 关键词：CHD ; Congenital heart disease ; FHP ; Fetal Heart Program
• 刊名：The Journal of Pediatrics
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：162
• 期：2
• 页码：302-307.e1
• 全文大小：128 K

文摘

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Objective

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.

Results

Fifty-nine mothers (gestational age 27 ¡À 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).

Conclusions

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