Schaap A H, Wolf H, Bruinse H W, Barkhof-van de Lande S, Treffers P E
Department of Obstetrics and Gynaecology, University of Amsterdam, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 1997 Dec;75(2):161-7. doi: 10.1016/s0301-2115(97)00127-9.
To investigate possible differences in emotional impact on parents following either a deliberate intrauterine death or a neonatal death in extremely preterm growth retarded infants.
Retrospectively matched study by audiotaped semi-structured interview, 3-9 years after the perinatal loss.
Nineteen couples (ten in the intrauterine death group and nine in the neonatal death group) consented to participate. More than 50% of the intrauterine death group couples could not share or discuss their emotions. Most partners in this group did not feel the loss of their own child. Discongruent grieving between partners was more pronounced in the intrauterine death group and could be identified as a risk factor for prolonged and abnormal grief reactions. Four couples (three in the intrauterine death group and one in the neonatal death group) developed long-term emotional disturbance and psychosocial problems. Long-term follow-up in both groups was failing remarkably.
Assimilating a non-intervention policy followed by fetal death requires different skills and is more complicated than grief support around an early neonatal death. Follow-up is essential to identify the couple 'at risk' and to mobilize extra support.
探讨极早早产生长受限婴儿发生故意宫内死亡或新生儿死亡后，父母所受情感影响的可能差异。
在围产期损失发生3至9年后，通过录音半结构化访谈进行回顾性匹配研究。
19对夫妇（宫内死亡组10对，新生儿死亡组9对）同意参与研究。宫内死亡组超过50%的夫妇无法分享或讨论他们的情绪。该组大多数伴侣并未感觉到自己孩子的离世。伴侣间悲伤情绪的不一致在宫内死亡组更为明显，可被视为长期及异常悲伤反应的一个风险因素。4对夫妇（宫内死亡组3对，新生儿死亡组1对）出现了长期的情绪障碍和心理社会问题。两组的长期随访情况均非常不理想。
接受胎儿死亡后的不干预政策需要不同的技巧，且比围绕新生儿早期死亡的悲伤支持更为复杂。随访对于识别“有风险”的夫妇并调动额外支持至关重要。
