Bardi Francesca, Bakker Merel, Kenkhuis Monique J A, Ranchor Adelita V, Bakker Marian K, Elvan-Taşpınar Ayten, Birnie Erwin, Bilardo Caterina M
Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
PLoS One. 2021 Jan 27;16(1):e0245938. doi: 10.1371/journal.pone.0245938. eCollection 2021.
The primary aim of this study is to investigate the impact of a 13-week anomaly scan on the experienced levels of maternal anxiety and well-being. Secondly, to explore women's knowledge on the possibilities and limitations of the scan and the preferred timing of screening for structural abnormalities.
In a prospective-cohort study conducted between 2013-2015, pregnant women in the North-Netherlands underwent a 13-week anomaly scan. Four online-questionnaires (Q1, Q2, Q3 and Q4) were completed before and after the 13- and the 20-week anomaly scans. In total, 1512 women consented to participate in the study and 1118 (74%) completed the questionnaires at Q1, 941 (64%) at Q2, 807 (55%) at Q3 and 535 (37%) at Q4. Psychological outcomes were measured by the state-trait inventory-scale (STAI), the patient's positive-negative affect (PANAS) and ad-hoc designed questionnaires.
Nine-nine percent of women wished to be informed as early as possible in pregnancy about the absence/presence of structural abnormalities. In 87% of women levels of knowledge on the goals and limitations of the 13-week anomaly scan were moderate-to-high. In women with a normal 13-week scan result, anxiety levels decreased (P < .001) and well-being increased over time (P < .001). In women with false-positive results (n = 26), anxiety levels initially increased (STAI-Q1: 39.8 vs. STAI-Q2: 48.6, P = 0.025), but later decreased around the 20-week anomaly scan (STAI-Q3: 36.4 vs. STAI-Q4: 34.2, P = 0.36).
The 13-week scan did not negatively impact the psychological well-being of pregnant women. The small number of women with screen-positive results temporarily experienced higher anxiety after the scan but, in false-positive cases, anxiety levels normalized again when the abnormality was not confirmed at follow-up scans. Finally, most pregnant women have moderate-to-high levels of knowledge and strongly prefer early screening for fetal structural abnormalities.
本研究的主要目的是调查13周异常扫描对孕妇焦虑和幸福感体验水平的影响。其次，探讨女性对扫描的可能性和局限性以及结构异常筛查的最佳时机的了解情况。
在2013年至2015年进行的一项前瞻性队列研究中，荷兰北部的孕妇接受了13周异常扫描。在13周和20周异常扫描前后完成了四份在线问卷（Q1、Q2、Q3和Q4）。共有1512名女性同意参与该研究，1118名（74%）在Q1完成问卷，941名（64%）在Q2完成问卷，807名（55%）在Q3完成问卷，535名（37%）在Q4完成问卷。心理结果通过状态-特质焦虑量表（STAI）、患者正负性情绪量表（PANAS）和专门设计的问卷进行测量。
99%的女性希望在孕期尽早得知结构异常的有无情况。87%的女性对13周异常扫描的目的和局限性的了解程度为中到高。13周扫描结果正常的女性，焦虑水平下降（P <.001），幸福感随时间增加（P <.001）。在假阳性结果的女性中（n = 26），焦虑水平最初升高（STAI-Q1：39.8 vs. STAI-Q2：48.6，P = 0.025），但在20周异常扫描前后有所下降（STAI-Q3：36.4 vs. STAI-Q4：34.2，P = 0.36）。
13周扫描对孕妇的心理健康没有负面影响。少数筛查结果为阳性的女性在扫描后暂时经历了更高的焦虑，但在假阳性病例中，当后续扫描未确认异常时，焦虑水平再次恢复正常。最后，大多数孕妇有中到高的了解程度，并且强烈倾向于早期筛查胎儿结构异常。
