The impact of diagnosed fetal anomaly, diagnostic severity and prognostic ambiguity on parental depression and traumatic stress: a prospective longitudinal cohort study. (14th September 2022)

• Record Type: Journal Article
• Authors: Oftedal, Aurora; Bekkhus, Mona; Haugen, Guttorm Nils; Czajkowski, Nikolai Olavi; Kaasen, Anne
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 101:Number 11(2022)
• Page Start: 1291
• Page End: 1299
• Publication Date: 2022-09-14
• Subjects: congenital malformation -- depression -- postpartum -- pregnancy -- prenatal diagnosis -- psychological distress -- traumatic stress; Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.14453
• Languages: English
• ISSNs: 0001-6349

Abstract

Abstract: Introduction: 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. Material and methods: 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). Results: 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. Conclusions: Diagnosis of fetal anomaly increases risk of depression and traumatic stress in expectant mothers and fathers, both acutely and over time. Abstract : This study examines the impact of diagnosis of fetal anomaly on parental depression and traumatic stress through pregnancy and after birth. We found that diagnosis of fetal anomaly increases risk of depression and traumatic stress acutely and over time. In particular, diagnostic severity, prognostic ambiguity and changes in diagnosis may increase the risk of persistent elevated distress.