Sherwood Molly R, Weathersby Bethany M, Granger Marion E, Shanahan Kathryn A, Markham Kara B
Allo Hope Foundation, Tuscaloosa, Alabama.
University of South Carolina, Columbia, South Carolina.
AJP Rep. 2025 Sep 8;15(3):e146-e153. doi: 10.1055/a-2690-9547. eCollection 2025 Jul.
The purpose of this study was to investigate mental health and impacts upon daily life in patients with a history of pregnancy alloimmunization, and secondarily to examine the relationship between disease severity and quality of care on these outcomes.
This was a survey administered between November 2022 and February 2023 to U.S. adults with a history of red cell alloimmunization in pregnancy. Mental health outcomes, quality of care, and daily life impacts were reported.
The survey was completed by 127 alloimmunized adults. Anxiety (90.6%), guilt (74.8%), self-doubt (68.0%), isolation (71.4%), depression (68.3%), and symptoms of posttraumatic stress disorder (PTSD) (61.3%) were frequently reported. Mental health support was offered in 24.4%. Respondents reporting a high quality of care in their alloimmunized pregnancies (rating of 8/10 or higher) were significantly less likely than those who perceived receiving lower-quality care to report feelings of guilt ( = 0.0006), self-doubt ( = 0.04), depression ( = 0.03), and symptoms of PTSD ( = 0.001).
Despite the pervasive patient burden, mental health support was infrequently offered, and patients reported low satisfaction with continuity of care and their providers' knowledge of alloimmunization. Clinicians interacting with alloimmunized patients must employ a comprehensive patient-centered approach to address the significant disease burden.
The impact of alloimmunization in pregnancy on patients' mental health and daily living has not been evaluated.Females with a history of alloimmunization in pregnancy reported widespread anxiety (115/127; 90.6%), guilt (95/127; 74.8%), self-doubt (85/127; 68.0%), isolation (90/127; 71.4%), depression (86/127; 68.3%), and symptoms of PTSD (76/127; 61.3%); mental health support was offered in 24.4% of the sample (31/127). Respondents reporting a high quality of care (rating of 8/10 or higher) were significantly less likely to report feelings of guilt ( = 0.0006), self-doubt ( = 0.04), depression ( = 0.03), and symptoms of PTSD ( = 0.001). This study highlights a need to utilize patient-centered comprehensive care models to support this rare high-risk population. Bolstered clinician knowledge and referral to peer support networks, mental health counselors, and social workers may prove highly beneficial to this patient population.
本研究旨在调查有妊娠同种免疫病史患者的心理健康状况及其对日常生活的影响，其次是检验疾病严重程度与这些结果的护理质量之间的关系。
这是一项于2022年11月至2023年2月对有妊娠红细胞同种免疫病史的美国成年人进行的调查。报告了心理健康结果、护理质量和对日常生活的影响。
127名接受同种免疫的成年人完成了调查。经常报告的症状有焦虑（90.6%）、内疚（74.8%）、自我怀疑（68.0%）、孤立感（71.4%）、抑郁（68.3%）和创伤后应激障碍（PTSD）症状（61.3%）。24.4%的人获得了心理健康支持。报告在同种免疫妊娠期间护理质量高（评分8/10或更高）的受访者比那些认为接受低质量护理的受访者报告内疚感（P = 0.0006）、自我怀疑（P = 0.04）、抑郁（P = 0.03）和PTSD症状（P = 0.001）的可能性显著降低。
尽管患者负担普遍存在，但心理健康支持很少提供，患者对护理连续性及其提供者对同种免疫的了解满意度较低。与接受同种免疫的患者互动的临床医生必须采用以患者为中心的综合方法来应对重大的疾病负担。
妊娠同种免疫对患者心理健康和日常生活的影响尚未得到评估。有妊娠同种免疫病史的女性报告普遍存在焦虑（115/127；90.6%）、内疚（95/127；74.8%）、自我怀疑（85/127；68.0%）、孤立感（90/127；71.4%）、抑郁（86/127；68.3%）和PTSD症状（76/127；61.3%）；24.4%的样本（31/127）获得了心理健康支持。报告护理质量高（评分8/10或更高）的受访者报告内疚感（P = 0.0006）、自我怀疑（P = 0.04）、抑郁（P = 0.03）和PTSD症状（P = 0.001）的可能性显著降低。本研究强调需要利用以患者为中心的综合护理模式来支持这一罕见的高危人群。增强临床医生的知识并转介至同伴支持网络、心理健康顾问和社会工作者可能对这一患者群体非常有益。
