Korenromp M J, Page-Christiaens G C M L, van den Bout J, Mulder E J H, Hunfeld J A M, Potters C M A A, Erwich J J H M, van Binsbergen C J M, Brons J T J, Beekhuis J R, Omtzigt A W J, Visser G H A
Department of Perinatology and Gynaecology, University Medical Centre Utrecht, The Netherlands.
Prenat Diagn. 2007 Aug;27(8):709-16. doi: 10.1002/pd.1763.
To identify short-term factors influencing psychological outcome of termination of pregnancy for fetal anomaly, in order to define those patients most vulnerable to psychopathology.
A prospective cohort of 217 women and 169 men completed standardized questionnaires 4 months after termination. Psychological adjustment was measured by the Inventory of Complicated Grief (ICG), the Impact of Event Scale (IES), the Edinburgh Postnatal Depression Scale (EPDS), and the Symptom Checklist-90 (SCL-90).
Women and men showed high levels of posttraumatic stress (PTS) symptoms (44 and 22%, respectively) and symptoms of depression (28 and 16%, respectively). Determinants of adverse psychological outcome were the following: high level of doubt in the decision period, inadequate partner support, low self-efficacy, lower parental age, being religious, and advanced gestational age. Whether the condition was Down syndrome or another disability was irrelevant to the outcome. Termination did not have an important effect on future reproductive intentions. Only 2% of women and less than 1% of men regretted the decision to terminate.
Termination of pregnancy (TOP) for fetal anomaly affects parents deeply. Four months after termination a considerable part still suffers from posttraumatic stress symptoms and depressive feelings. Patients who are at high risk could benefit from intensified support.
确定影响因胎儿异常而终止妊娠心理结局的短期因素，以便界定那些最易出现精神病理学问题的患者。
一个由217名女性和169名男性组成的前瞻性队列在终止妊娠4个月后完成了标准化问卷调查。采用复杂哀伤量表（ICG）、事件影响量表（IES）、爱丁堡产后抑郁量表（EPDS）和症状自评量表90（SCL-90）来测量心理调适情况。
女性和男性均表现出较高水平的创伤后应激（PTS）症状（分别为44%和22%）以及抑郁症状（分别为28%和16%）。不良心理结局的决定因素如下：在决策期的高度怀疑、伴侣支持不足、自我效能感低、父母年龄较小、信教以及孕周较大。胎儿疾病是唐氏综合征还是其他残疾与结局无关。终止妊娠对未来生育意愿没有重要影响。只有2%的女性和不到1%的男性后悔终止妊娠的决定。
因胎儿异常而终止妊娠对父母影响深远。终止妊娠4个月后，相当一部分人仍遭受创伤后应激症状和抑郁情绪的困扰。高危患者可能会从强化支持中受益。
