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产前诊断出致命胎儿缺陷后继续妊娠及参加有组织的宗教活动与改善心理结局相关。

Pregnancy continuation and organizational religious activity following prenatal diagnosis of a lethal fetal defect are associated with improved psychological outcome.

作者信息

Cope Heidi, Garrett Melanie E, Gregory Simon, Ashley-Koch Allison

机构信息

Center for Human Disease Modeling, Duke University Medical Center, Durham, NC, USA.

Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA.

出版信息

Prenat Diagn. 2015 Aug;35(8):761-768. doi: 10.1002/pd.4603. Epub 2015 May 26.

Abstract

OBJECTIVE

The aim of the article is to examine the psychological impact, specifically symptoms of grief, post-traumatic stress and depression, in women and men who either terminated or continued a pregnancy following prenatal diagnosis of a lethal fetal defect.

METHOD

This project investigated a diagnostically homogeneous group composed of 158 women and 109 men who lost a pregnancy to anencephaly, a lethal neural tube defect. Participants completed the Perinatal Grief Scale, Impact of Event Scale - Revised and Beck Depression Inventory-II, which measure symptoms of grief, post-traumatic stress and depression, respectively. Demographics, religiosity and pregnancy choices were also collected. Gender-specific analysis of variance was performed for instrument total scores and subscales.

RESULTS

Women who terminated reported significantly more despair (p = 0.02), avoidance (p = 0.008) and depression (p = 0.04) than women who continued the pregnancy. Organizational religious activity was associated with a reduction in grief (Perinatal Grief Scale subscales) in both women (p = 0.02, p = 0.04 and p = 0.03) and men (p = 0.047).

CONCLUSION

There appears to be a psychological benefit to women to continue the pregnancy following a lethal fetal diagnosis. Following a lethal fetal diagnosis, the risks and benefits, including psychological effects, of termination and continuation of pregnancy should be discussed in detail with an effort to be as nondirective as possible.

摘要

目的

本文旨在研究在产前诊断出致命胎儿缺陷后终止或继续妊娠的女性和男性的心理影响,特别是悲伤、创伤后应激和抑郁症状。

方法

该项目调查了一个诊断同质的群体,由158名女性和109名男性组成,他们因无脑儿(一种致命的神经管缺陷)而失去妊娠。参与者完成了围产期悲伤量表、事件影响量表修订版和贝克抑郁量表第二版,分别测量悲伤、创伤后应激和抑郁症状。还收集了人口统计学、宗教信仰和妊娠选择等信息。对量表总分和子量表进行了性别特异性方差分析。

结果

终止妊娠的女性比继续妊娠的女性报告的绝望感(p = 0.02)、回避情绪(p = 0.008)和抑郁情绪(p = 0.04)明显更多。有组织的宗教活动与女性(p = 0.02、p = 0.04和p = 0.03)和男性(p = 0.047)悲伤情绪的减轻(围产期悲伤量表子量表)相关。

结论

对于女性来说,在诊断出致命胎儿缺陷后继续妊娠似乎有心理益处。在诊断出致命胎儿缺陷后,应详细讨论终止妊娠和继续妊娠的风险和益处,包括心理影响,并尽量做到非指导性。

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Survey of physicians' approach to severe fetal anomalies.对医师处理严重胎儿畸形方法的调查。
J Med Ethics. 2012 Jul;38(7):391-5. doi: 10.1136/medethics-2011-100340. Epub 2012 Jan 19.

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