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Prenatal CHD diagnosis increased maternal stress, depression and anxiety

Posttraumatic stress, depression and anxiety were common in mothers after receiving prenatal diagnoses of coronary heart disease, according to study results.

“Maternal psychological distress has been linked to fetal disturbances in the hypothalamic-adrenal-pituitary system axis, poor intrauterine growth, pre-term delivery, and small of gestational age newborns,” the researchers wrote.

Jack Rychik, MD, and colleagues from The Children’s Hospital of Philadelphia (CHOP) performed psychological assessments of women carrying fetuses with serous coronary heart disease (CHD), requiring neonatal evaluation, cardiac surgery or catheterization within 6 months of birth at CHOP’s Fetal Heart Program.

A series of validated scales were used to assess posttraumatic stress, anxiety, severity of depression symptoms, coping responses and couples/partner adjustment.

Results showed that 39% of women had traumatic stress, 22% had depression and 31% had anxiety. Reports of lower partner satisfaction were associated with higher depression (P<.01) and higher anxiety (P<.01). Controlling for partner satisfaction and income, Rychik and colleagues found that denial was associated with increased traumatic stress, anxiety and depression (P<.01).

Women may grieve the loss of a “normal” pregnancy, moving in and out of the various stages of denial, guilt, anger, bargaining and, finally, acceptance — a psychological trajectory that could help health care providers understand the mental health of women carrying a fetus with CHD, according to the researchers.

“In order to improve maternal health and, consequently, fetal health, our study suggests that health care providers should look to promote the coping skills of acceptance and positive reinterpretation and growth among women pregnant with a fetus diagnosed with CHD,” they wrote.

Rychik and colleagues added that partner satisfaction could act as a “buffer” for stress associated with prenatal CHD.

Disclosure: The researchers report no relevant financial disclosures.