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-变异携带者新生儿对母亲的心理影响及咨询:一项儿科监测队列研究

Psychological Impact of -Variant-Carrier Newborns and Counselling on Mothers: A Pediatric Surveillance Cohort.

作者信息

Gozdziejewski Amanda Scartezini, Zotti Clarice Wichinescki, de Carvalho Isabela Aparecida Moreira, Dos Santos Thairine Camargo, de Santi Walter Luana Rayana, Ogradowski Karin Rosa Persegona, Dammski Karin Luiza, Komechen Heloisa, Mendes Monalisa Castilho, de Souza Emanuelle Nunes, Paraizo Mariana Martins, da Silva Parise Ivy Zortea, Parise Guilherme Augusto, Grion André Luiz, Custódio Gislaine, Mello Rosiane Guetter, Figueiredo Bonald C

机构信息

Pelé Pequeno Príncipe Research Institute, 1532 Silva Jardim, AV., Curitiba 80250-200, PR, Brazil.

Faculdades Pequeno Príncipe, 333 Iguaçu Av., Rebouças, Curitiba 80230-902, PR, Brazil.

出版信息

Cancers (Basel). 2022 Jun 15;14(12):2945. doi: 10.3390/cancers14122945.

Abstract

Counselling and genetic testing (CGT) after neonatal screening may increase depression and anxiety (DA) levels during cancer surveillance. This study assessed the DA scores in mothers of newborns from Paraná state, Southern Brazil, carrying the p.R337H variant. To understand and adjust DA conditions during term of pregnancy, we initially detected sociodemographic covariates [marital status (MS), number of children (NC), and/or education level (EL): MS-NC-EL] on an independent group of pregnant women (not subjected to genetic testing). The Hospital Anxiety and Depression Scale (HADS) was used to assess risk factors in pregnant (cross-sectional analysis) and unrelated mothers (at 2-month intervals, longitudinal study) of p.R337H-tested newborns (three sessions of HADS analysis) using Wilcoxon (Mann-Whitney) and Kruskal-Wallis nonparametric tests. Lower anxiety levels were observed in mothers of noncarriers (without MS-NC-EL = 6.91 ± 1.19; with MS-NC-EL = 6.82 ± 0.93) than in mothers of p.R337H carriers in the first session (without MS-NC-EL = 6.82 = 8.49 ± 0.6025, with MS-NC-EL = 6.82 = 9.21 ± 0.66). The anxiety levels significantly decreased 4 months after CGT (third session) in mothers of p.R337H carriers. We did not find a significant change in depression scores. Mothers with mental health instability requiring medications need periodical psychological support during and after CGT.

摘要

新生儿筛查后的咨询与基因检测(CGT)可能会增加癌症监测期间的抑郁和焦虑(DA)水平。本研究评估了巴西南部巴拉那州携带p.R337H变异的新生儿母亲的DA评分。为了解和调整孕期的DA状况,我们首先在一组独立的孕妇(未接受基因检测)中检测社会人口统计学协变量[婚姻状况(MS)、子女数量(NC)和/或教育水平(EL):MS-NC-EL]。使用医院焦虑抑郁量表(HADS),通过Wilcoxon(Mann-Whitney)和Kruskal-Wallis非参数检验,评估接受p.R337H检测的新生儿的孕妇(横断面分析)和非相关母亲(每隔2个月进行一次,纵向研究)中的风险因素(进行三次HADS分析)。在第一阶段,非携带者母亲(无MS-NC-EL = 6.91±1.19;有MS-NC-EL = 6.82±0.93)的焦虑水平低于p.R337H携带者母亲(无MS-NC-EL = 6.82 = 8.49±0.6025,有MS-NC-EL = 6.82 = 9.21±0.66)。在CGT后四个月(第三阶段),p.R337H携带者母亲的焦虑水平显著下降。我们未发现抑郁评分有显著变化。心理健康不稳定需要药物治疗的母亲在CGT期间及之后需要定期的心理支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea0/9221115/6fd7f130d403/cancers-14-02945-g001.jpg

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