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Symptoms of Perinatal Mood Disorders in Expectant Parents with a Diagnosis of a Congenital Anomaly

American journal of obstetrics and gynecology(2023)

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摘要
To assess frequency of depressive and traumatic stress symptoms in parents following a fetal diagnosis. To evaluate whether diagnosis type, demographics or prematurity were associated with heightened psychological distress. Postpartum Depression Screening Scale (PDSS) and Center for Epidemiological Studies-Depression (CES-D) were used to identify clinically significant symptoms of depressive risk ( ≥ 60 and ≥ 21) and The Impact of Events Scale-Revised (IES-R) was used to determine traumatic stress risk ( ≥ 33) in a cohort of pregnant patients and their partners at a single center with onsite psychosocial services from 2013-2022. Expectant parents completed screens following diagnosis of a fetal anomaly (Time 1) and immediately postpartum (Time 2). Change over time was defined by improvement from positive to negative screen between Time 1 and Time 2. Sociodemographic variables, type of fetal anomaly and gestational age at delivery were assessed. Statistical analysis was performed using Fisher's exact test and chi-square test for categorical variables and Mann-Whitney U test for continuous variables. Rates of clinically significant depressive and traumatic stress risk for patients and partners are presented in the Table. Risk decreased significantly in all groups over time. Demographics including age, race/ethnicity, education level, and insurance did not significantly impact change in symptoms between screens. Anomaly type did not impact change over time for depressive or traumatic stress symptoms. Prematurity was not associated with significant change in symptoms at time 2. Diagnosis of a fetal anomaly is associated with heightened parental psychological distress. Clinically significant decline in symptoms was demonstrated at birth. Findings support the importance of implementing mental health screening and availability of psychosocial support services in maternal-fetal care settings to address anticipatory concerns and normalize the emotional distress during the perinatal period among expectant parents.
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