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先天性异常的产前咨询:一项系统评价

Prenatal counselling for congenital anomalies: a systematic review.

作者信息

Marokakis Sarah, Kasparian Nadine A, Kennedy Sean E

机构信息

Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.

Heart Centre for Children, The Sydney Children's Hospitals Network (Westmead and Randwick), Sydney, NSW, Australia.

出版信息

Prenat Diagn. 2016 Jul;36(7):662-71. doi: 10.1002/pd.4836. Epub 2016 Jun 3.

Abstract

OBJECTIVE

Prenatal diagnosis of fetal anomalies may arouse fear, anxiety and distress in parents, and counselling may assist parents to cope with the diagnosis. This systematic review aimed to (1) synthesise the evidence on the impact of non-genetic, prenatal counselling after fetal diagnosis of a congenital anomaly on parental knowledge and psychological adjustment and (2) identify parents' preferences for the timing and format of counselling.

METHOD

Five electronic databases were systematically searched to identify studies assessing prenatal counselling provided to parents after prenatal diagnosis of one or more structural congenital anomalies. Data were extracted using predefined data forms, according to the preferred reporting items for systematic reviews and meta-analyses guidelines, and synthesised.

RESULT

Twenty four articles were included for review; most articles reported results of retrospective surveys and the quality of included studies was variable. Only three studies assessed parental anxiety, and each reported a significant decrease in anxiety following prenatal counselling. Parents expressed a preference for counselling on all aspects of their baby's anomaly as soon as possible after prenatal diagnosis, and desired written, visual and web-based information resources, and support group contacts.

CONCLUSION

Although prenatal counselling reduced parental anxiety, further research is needed to adequately assess the impact of prenatal counselling on other psychological outcomes. © 2016 John Wiley & Sons, Ltd.

摘要

目的

胎儿异常的产前诊断可能会引起父母的恐惧、焦虑和痛苦,而咨询可能有助于父母应对诊断结果。本系统评价旨在:(1)综合关于胎儿先天性异常诊断后非基因产前咨询对父母知识及心理调适影响的证据;(2)确定父母对咨询时间和形式的偏好。

方法

系统检索五个电子数据库,以识别评估在产前诊断出一种或多种结构性先天性异常后向父母提供产前咨询的研究。根据系统评价和Meta分析的首选报告项目指南,使用预定义的数据表提取数据并进行综合分析。

结果

纳入24篇文章进行综述;大多数文章报告了回顾性调查结果,纳入研究的质量参差不齐。只有三项研究评估了父母的焦虑,每项研究均报告产前咨询后焦虑显著降低。父母表示希望在产前诊断后尽快就其宝宝异常的各个方面接受咨询,并希望获得书面、视觉和基于网络的信息资源以及支持小组联系方式。

结论

尽管产前咨询减轻了父母的焦虑,但仍需要进一步研究以充分评估产前咨询对其他心理结果的影响。© 2016约翰威立父子有限公司

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