Lykeridou Katerina, Daskalakis George, Papadatou Danai, Vaslamatzis Grigoris, Dafni Ourania, Antsaklis Aris
1st Department of Obstetrics and Gynaecology, University of Athens, Athens, Greece.
Fetal Diagn Ther. 2004 Mar-Apr;19(2):149-54. doi: 10.1159/000075140.
The aim of the study was to investigate the levels of anxiety and depression, as well as liability to depression, of women undergoing chorionic villus sampling (CVS) due to the risk of giving birth to a child suffering from hemoglobinopathy, or trisomy.
The study population consisted of 309 women who attended the Fetal Medicine Unit of Alexandra Hospital, University of Athens, Athens, Greece for a first trimester chorionic villus sampling (CVS). One hundred and fifty-nine women (group A) underwent CVS due to increased possibility of carrying an embryo with beta-thalassemia, while 150 women had the procedure because of an increased nuchal translucency measurement, or a positive first trimester biochemical screening (group B). Three hundred and nine women, matched by age and gestational age with those of the study group, who were not subjected to any diagnostic intervention formed the control group. We further investigated differences of dysthymic reactions among three subgroups of women at risk for hemoglobinopathy: (a) women undergoing their first pregnancy; (b) women who had been pregnant more than once but had not any children, and (c) women who had given birth to at least one healthy child, irrespective of previous terminations.
The incidence of clinically elevated levels of anxiety and depression was significantly higher in groups A and B compared to controls (p<0.001), while no significant difference was found in mean anxiety and depression, as well as the liability to depression among the three groups. Clinically elevated levels of depression were found in 10.1 and 4.7% of the women of the hemoglobinopathy and karyotyping group, respectively. Especially women who had no children, due to previous pregnancy terminations presented significantly higher incidence of elevated depression compared to women who were pregnant for the first time, or women who had given birth to at least one healthy child in their life.
The findings of this study highlight the necessity of training medical and nursing personnel to understand and respond to the psychological and social needs of women undergoing CVS due to increased risk for hemoglobinopathy, and especially to those who have no children and who have a history of pregnancy termination due to an affected fetus.
本研究旨在调查因有生育患血红蛋白病或三体综合征患儿风险而接受绒毛取样（CVS）的女性的焦虑和抑郁水平，以及抑郁倾向。
研究人群包括309名前往希腊雅典大学亚历山德拉医院胎儿医学科进行孕早期绒毛取样（CVS）的女性。159名女性（A组）因怀有患β地中海贫血胚胎的可能性增加而接受CVS，而150名女性因颈项透明层测量值增加或孕早期生化筛查呈阳性而进行该检查（B组）。309名年龄和孕周与研究组匹配且未接受任何诊断干预的女性组成对照组。我们进一步调查了血红蛋白病风险女性的三个亚组中恶劣心境反应的差异：（a）首次怀孕的女性；（b）怀孕不止一次但没有孩子的女性，以及（c）至少生育过一个健康孩子的女性，无论之前是否有过终止妊娠。
A组和B组临床焦虑和抑郁水平升高的发生率显著高于对照组（p<0.001），而三组之间的平均焦虑和抑郁水平以及抑郁倾向没有显著差异。血红蛋白病组和染色体核型分析组分别有10.1%和4.7%的女性临床抑郁水平升高。特别是那些因之前终止妊娠而没有孩子的女性，与首次怀孕的女性或一生中至少生育过一个健康孩子的女性相比，抑郁水平升高的发生率显著更高。
本研究结果强调了培训医护人员以理解并回应因血红蛋白病风险增加而接受CVS的女性的心理和社会需求的必要性，尤其是那些没有孩子且因胎儿患病而有终止妊娠史的女性。
