Kowalcek I, Mühlhoff A, Bachmann S, Gembruch U
Division of Prenatal Medicine, Department of Obstetrics and Gynaecology, Medical University of Lübeck, Germany.
Ultrasound Obstet Gynecol. 2002 Jan;19(1):18-23. doi: 10.1046/j.0960-7692.2001.00551.x.
The experience of pregnancy is mainly influenced by the availability of prenatal screening procedures. Previous screening studies focus on somatic abnormalities. The psychological experience of the parents-to-be recedes into the background. The purpose of the present study was to analyze the emotional mood of pregnant women and their partners before and their psychological stress before and after different prenatal screening procedures (ultrasound, chorionic villus sampling or amniocentesis).
In the study, 140 pregnant women, and, in 108 cases, their partners, were asked to complete questionnaires before and immediately after the prenatal testing. Depending on the applied prenatal procedure, the subjects were assigned to: the invasive group (amniocentesis or chorionic villus sampling) and the noninvasive group (ultrasound group). We used the German version of the Centre for Epidemiological Studies-Depression Scale of Hautzinger and the short questionnaire of actual situative perceived stress of Müller.
Before the prenatal examination, the mean level of depression of pregnant women was the highest in the noninvasive group compared to the invasive group, although the between-group difference was not significant. However, for their male partners, the mean level of depression was significantly different between the noninvasive and the invasive groups. Furthermore, women undergoing invasive diagnostic or noninvasive diagnostic procedures were significantly more depressed than their partners. The analysis of the actual stress ratings showed a significant reduction from the prescreening to the postscreening stress for pregnant women and their partners in both groups.
This study reveals that the individual experience of prenatal diagnosis is not determined by the invasiveness of the procedure. Immediate visual presentation of the fetus and confirmation of a normal test result reduce stress that has previously been induced by the prenatal test itself. This contradiction should be discussed with the parents.
怀孕体验主要受产前筛查程序可用性的影响。以往的筛查研究主要关注躯体异常。准父母的心理体验则退居次要地位。本研究的目的是分析孕妇及其伴侣在不同产前筛查程序(超声、绒毛取样或羊膜穿刺术)前后的情绪状态以及心理压力。
在本研究中,140名孕妇及其伴侣中的108名被要求在产前检查前和检查后立即完成问卷。根据所采用的产前程序,将受试者分为:侵入性组(羊膜穿刺术或绒毛取样)和非侵入性组(超声组)。我们使用了豪青格的德国版流行病学研究中心抑郁量表以及米勒的实际情境感知压力简短问卷。
产前检查前,与侵入性组相比,非侵入性组孕妇的平均抑郁水平最高,尽管组间差异不显著。然而,对于其男性伴侣,非侵入性组和侵入性组之间的平均抑郁水平存在显著差异。此外,接受侵入性诊断或非侵入性诊断程序的女性比其伴侣明显更抑郁。对实际压力评分的分析表明,两组孕妇及其伴侣从筛查前到筛查后的压力均显著降低。
本研究表明,产前诊断的个体体验并非由程序的侵入性决定。胎儿的即时视觉呈现以及检测结果正常的确认减轻了先前由产前检查本身所引发的压力。应与准父母讨论这一矛盾之处。