Handling Tough News When Pregnant

Prenatal diagnosis of congenital heart disease can increase stress and anxiety for mom

(RxWiki News) It's a catch-22. If you find out your child has a heart defect before he's born, you can prepare. But it can also stress out mom — which can affect the baby as well.

The solution is to find positive ways to cope with the stress that can come with prenatal testing.

A recent study has found that pregnant moms tend to suffer more stress, depression and anxiety after finding out their child has a heart problem through prenatal testing.

"Seek support for tough news."

The study, led by Jack Rychik, MD, from the Fetal Heart Program at The Cardiac Center in The Children's Hospital of Philadelphia, wanted to find out how women dealt with the news of their child's diagnosis.

The researchers surveyed 59 pregnant women about their psychological symptoms and mental health about two to four weeks after their child was prenatally diagnosed with congenital heart disease.

The surveys asked about the women's anxiety and depression levels, post traumatic stress symptoms, ways of coping with the news and their relationship with their partner.

About a third of the women had anxiety, 22 percent had depression, and 39 percent had traumatic stress.

These responses were compared against those of pregnant women carrying children that were not diagnosed with a heart condition before birth.

The pregnant women who had been informed of their child's heart defect had higher levels of depression and anxiety than the pregnant women with healthy babies.

The mothers of the unborn babies with heart disease also reported lower satisfaction with their partner.

Those women who reported lower partner satisfaction were more likely to experience depression and anxiety, so the authors suggested that couples therapy may be helpful for these women.

Lower income women were more likely to report depression.

But the worst outcomes were among the women who denied the problem existed.

Those who were in denial of their child's condition had higher levels of depression, anxiety and traumatic stress, regardless of their income or how they felt about their partner.

Meanwhile, those women who accepted the situation more had lower rates of depression.

One reason to test for congenital heart problems is that it allows parents to learn about these conditions and plan ahead, especially if surgery is an option.

Babies with congenital heart disease who are identified before birth also tend to be more stable and have better outcomes than babies not identified ahead of time.

The challenge is that health providers now know finding out about these heart disease conditions can lead to higher stress levels for the woman carrying the child.

Higher levels of stress in pregnant women have been linked to poor growth in the uterus, having a child early, underweight newborns and disruptions in the unborn baby's endocrine system.

"Our study supports the notion that maternal psychological support is an important intervention that may someday accompany prenatal diagnosis of congenital heart disease, in order to potentially improve outcomes for both fetus and mother," said Dr. Rychik.

The study was published September 7 in The Journal of Pediatrics. The study was funded by the Robert and Dolores Harrington Endowment at the Children’s Hospital of Philadelphia and, through one author, in part by the Robert and Dolores Harrington Endowed Chair in Pediatric Cardiology. The authors declared no conflicts of interest.

Review Date: 
September 4, 2012