Expectant mothers who learn that they are carrying a fetus with a congenital heart defect (CHD) commonly suffer post-traumatic stress, depression and anxiety. However, according to new research from The Children's Hospital of Philadelphia's Cardiac Center, a healthy relationship with one's partner and positive coping mechanisms can reduce this intense stress.
"Receiving the news of carrying a fetus with a CHD is a stressful event which can potentially influence a mother's anxiety level," said study leader Jack Rychik, MD, FACC, director of the Cardiac Center's Fetal Heart Program.
"Prenatal diagnosis is helpful in that it gives parents time to learn about the defect, review treatment options, plan for necessary interventions and consider their options. While this is intrinsically a stressful time for parents, there has previously been little research on the details of this stress and ways to buffer it," Dr. Rychik added. The study was published recently in The Journal of Pediatrics.
The researchers surveyed 59 pregnant mothers, ranging in gestational age from 17 to 31.5 weeks, who intended to continue their pregnancies. All were carrying fetuses with serious CHD, requiring neonatal evaluation and postnatal surgical or catheter-based intervention within the first six months of life. Using psychological evaluation tools and self-reporting instruments, the study team measured traumatic stress, depression and anxiety among the mothers. The researchers also measured partner satisfaction and collected demographic data.
Dr. Rychik and his team found that more than 39 percent of the women experienced clinically important traumatic stress, while 22 percent experienced depression, and 31 percent experienced state anxiety. Lower partner satisfaction and lower income were both associated with higher levels of depression, anxiety, and traumatic stress. When the researchers controlled for partner satisfaction and income, they found denial to be most important factor contributing to depression.
"This study is the beginning, and more research needs to be done to ensure we are giving mothers the very best multidisciplinary care," Dr. Rychik pointed out, adding that in "the future, optimal management strategies to improve outcomes for both mom and fetus will include stress reduction techniques, which should accompany the diagnosis of CHD prior to birth."