Bratt Ewa-Lena, Järvholm Stina, Ekman-Joelsson Britt-Marie, Johannsmeyer Antje, Carlsson Sven-Åke, Mattsson Lars-Åke, Mellander Mats
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Pediatric Cardiology, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
Cardiol Young. 2019 Nov;29(11):1328-1334. doi: 10.1017/S1047951119001781. Epub 2019 Sep 16.
A diagnosis of congenital heart disease (CHD) in offspring triggers psychological distress in parents. Results of previous studies have been inconsistent regarding the psychological impact of a prenatal versus a postnatal diagnosis. The aim of this study was to evaluate the influence of the time of diagnosis on levels of parental distress.
Pregnant women and their partners with a fetus diagnosed with complex CHD, parents of children with postnatally diagnosed CHD, and pregnant women and their partners with uncomplicated pregnancies were invited to participate. Data were collected during pregnancy and 2-6 months after delivery using the Hospital Anxiety and Depression Scale, sense of coherence, life satisfaction, and Dyadic Adjustment Scale.
During pregnancy, the prenatal group scored lower sense of coherence compared to controls (p=0.044). Postnatally the prenatal group scored lower on sense of coherence compared to the postnatal group and controls (p=0.001; p=0.001). Postnatally, the prenatal and postnatal groups had higher levels of anxiety compared to controls (p=0.025; p=0.0003). Life satisfaction was lower in the prenatal group compared to that in the postnatal group and in controls (p=0.000; p=0.0004).
Parents with a prenatal diagnosis of CHD in offspring report a low sense of coherence already during pregnancy which decreased further at follow-up. The same group reported a lower satisfaction with life compared to parents of a child with postnatal diagnosis of CHD and parents of a healthy child. This motivates further efforts to improve counselling and support during pregnancy and for parents after a prenatal diagnosis.
后代被诊断患有先天性心脏病（CHD）会引发父母的心理困扰。先前研究的结果在产前诊断与产后诊断的心理影响方面并不一致。本研究的目的是评估诊断时间对父母困扰程度的影响。
邀请被诊断患有复杂CHD胎儿的孕妇及其伴侣、产后被诊断患有CHD儿童的父母，以及妊娠情况正常的孕妇及其伴侣参与研究。在孕期以及分娩后2至6个月期间，使用医院焦虑抑郁量表、心理一致感量表、生活满意度量表和夫妻调适量表收集数据。
孕期，产前诊断组的心理一致感得分低于对照组（p = 0.044）。产后，产前诊断组的心理一致感得分低于产后诊断组和对照组（p = 0.001；p = 0.001）。产后，产前诊断组和产后诊断组的焦虑水平均高于对照组（p = 0.025；p = 0.0003）。产前诊断组的生活满意度低于产后诊断组和对照组（p = 0.000；p = 0.0004）。
后代产前被诊断患有CHD的父母在孕期就报告心理一致感较低，且在随访时进一步下降。与产后被诊断患有CHD儿童的父母以及健康儿童的父母相比，该组对生活的满意度较低。这促使我们进一步努力，在孕期以及产前诊断后为父母提供更好的咨询和支持。
