Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Department of Psychology, Promenta Research Center, University of Oslo, Oslo, Norway.
Acta Obstet Gynecol Scand. 2022 Nov;101(11):1291-1299. doi: 10.1111/aogs.14453. Epub 2022 Sep 14.
The detection of a fetal anomaly during routine obstetric ultrasound is a potentially traumatic experience. The aim of this study is to examine longitudinally the impact of diagnosis of fetal anomaly on symptoms of depression and traumatic stress among mothers and fathers, and to examine how variations in psychological adjustment relate to diagnostic severity and prognostic ambiguity.
In this prospective observational study conducted at a tertiary perinatal referral center, 81 mothers and 69 fathers with ultrasound findings of fetal anomaly completed the Edinburgh Postnatal Depression Scale (EPDS) and Impact of Events Scale (IES) at four time points in pregnancy (T1-T4) and 6 weeks after birth (T5). We compared this with depression and traumatic stress in a sample of non-affected parents (n = 110 mothers, 98 fathers).
Linear mixed effects models indicated that parents who received a diagnosis of fetal anomaly experienced higher levels of depression and traumatic stress over time, compared with non-affected parents. Depression: mean difference mothers = 4.46 ± 0.47, fathers = 2.80 ± 0.42. Traumatic stress: mean difference mothers = 20.04 ± 2.13, fathers = 12.66 ± 1.74. Parents with a more severe diagnosis experienced elevated symptoms compared with parents with a less severe diagnosis. Among mothers, prognostic ambiguity and changes in the anticipated diagnosis after birth were also associated with increased distress, regardless of whether the change was for the better or worse.
Diagnosis of fetal anomaly increases risk of depression and traumatic stress in expectant mothers and fathers, both acutely and over time.
在常规产科超声检查中发现胎儿异常是一种潜在的创伤性体验。本研究旨在纵向研究诊断胎儿异常对母亲和父亲抑郁和创伤后应激症状的影响，并研究心理适应的变化如何与诊断严重程度和预后不明确相关。
在一家三级围产期转诊中心进行的这项前瞻性观察性研究中，81 名母亲和 69 名父亲在妊娠的四个时间点（T1-T4）和产后 6 周（T5）完成了爱丁堡产后抑郁量表（EPDS）和事件影响量表（IES）。我们将这些结果与未受影响的父母样本（n=110 名母亲，98 名父亲）的抑郁和创伤后应激进行了比较。
线性混合效应模型表明，与未受影响的父母相比，接受胎儿异常诊断的父母随着时间的推移经历了更高水平的抑郁和创伤后应激。抑郁：母亲的平均差异=4.46±0.47，父亲=2.80±0.42。创伤后应激：母亲的平均差异=20.04±2.13，父亲=12.66±1.74。诊断更严重的父母比诊断较轻的父母症状更严重。在母亲中，预后不明确和出生后预期诊断的变化也与增加的痛苦相关，无论变化是变好还是变坏。
胎儿异常的诊断增加了孕妇和父亲在急性和长期内患抑郁和创伤后应激的风险。
