Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
Department of Obstetrics and Gynaecology, Hospital Tunku Azizah, Kuala Lumpur 50586, Malaysia.
Int J Environ Res Public Health. 2021 Dec 7;18(24):12900. doi: 10.3390/ijerph182412900.
Prenatal ultrasonographic detection of fetal structural anomaly may adversely affect maternal mental health throughout pregnancy, particularly in the current COVID-19 pandemic. This study aims to prospectively assess maternal stress, anxiety, and depression following ultrasonographic detection of fetal structural anomaly from diagnosis until delivery during the COVID-19 pandemic. A total of 141 pregnant women at a tertiary hospital who underwent detailed scans between 16 and 24 gestational weeks were included and categorized into the study (anomaly finding, = 65) and comparison (normal finding, = 76) groups. Self-administered questionnaires of 10-item Perceived Stress Scale (PSS-10) and Hospital Anxiety and Depression Scale (HADS) were used to assess maternal stress, anxiety, and depression at prior detection (T), two-to-four weeks post-detection (T), one-to-two weeks prior to delivery (T), and one-to-two weeks post-delivery (T). Repeated measures of analysis of variance (ANOVA) were conducted to assess time-, between-group, and time-group interaction effect. In general, maternal stress improved, but anxiety worsened, while depression persisted, over the time from T to T. The average maternal stress and anxiety levels were significantly higher among groups with fetal anomaly. The maternal stress and anxiety level were significantly affected within one-to-two weeks post-detection of fetal structural anomaly. In conclusion, maternal mental health parameters were affected differently during the COVID-19 pandemic, with higher vulnerability of stress and anxiety among pregnant women with fetal structural anomaly particularly within one-to-two weeks post-detection.
产前超声检查发现胎儿结构异常可能会在整个孕期对产妇的心理健康产生不利影响,尤其是在当前的 COVID-19 大流行期间。本研究旨在前瞻性评估 COVID-19 大流行期间,在超声检查发现胎儿结构异常后,从诊断到分娩期间,产妇的应激、焦虑和抑郁情况。共纳入了 141 名在一家三级医院进行 16-24 孕周详细超声检查的孕妇,并将其分为研究组(异常发现,n=65)和对照组(正常发现,n=76)。使用 10 项感知压力量表(PSS-10)和医院焦虑抑郁量表(HADS)的自填式问卷,在检测前(T)、检测后 2-4 周(T)、分娩前 1-2 周(T)和分娩后 1-2 周(T)评估产妇的应激、焦虑和抑郁情况。采用重复测量方差分析(ANOVA)评估时间、组间和时间-组间交互作用的影响。总的来说,从 T 到 T,产妇的应激有所改善,但焦虑恶化,而抑郁持续存在。在有胎儿异常的组中,产妇的平均应激和焦虑水平显著较高。在检测到胎儿结构异常后的 1-2 周内,产妇的应激和焦虑水平显著受到影响。总之,在 COVID-19 大流行期间,产妇的心理健康参数受到不同的影响,特别是在检测到胎儿结构异常后的 1-2 周内,有胎儿结构异常的孕妇的应激和焦虑水平的脆弱性更高。