Parental reactions, distress, and sense of coherence after prenatal versus postnatal diagnosis of complex congenital heart disease

Abstract

Introduction:A diagnosis of congenital heart disease (CHD) in offspring triggers psychological distress in parents. Results of previous studies have been inconsistent regarding the psychological impact of a prenatal versus a postnatal diagnosis. The aim of this study was to evaluate the influence of the time of diagnosis on levels of parental distress.Methods:Pregnant women and their partners with a fetus diagnosed with complex CHD, parents of children with postnatally diagnosed CHD, and pregnant women and their partners with uncomplicated pregnancies were invited to participate. Data were collected during pregnancy and 2–6 months after delivery using the Hospital Anxiety and Depression Scale, sense of coherence, life satisfaction, and Dyadic Adjustment Scale.Results:During pregnancy, the prenatal group scored lower sense of coherence compared to controls (p=0.044). Postnatally the prenatal group scored lower on sense of coherence compared to the postnatal group and controls (p=0.001; p=0.001). Postnatally, the prenatal and postnatal groups had higher levels of anxiety compared to controls (p=0.025; p=0.0003). Life satisfaction was lower in the prenatal group compared to that in the postnatal group and in controls (p=0.000; p=0.0004).Conclusion:Parents with a prenatal diagnosis of CHD in offspring report a low sense of coherence already during pregnancy which decreased further at follow-up. The same group reported a lower satisfaction with life compared to parents of a child with postnatal diagnosis of CHD and parents of a healthy child. This motivates further efforts to improve counselling and support during pregnancy and for parents after a prenatal diagnosis.

Risk factors of necrotizing enterocolitis in neonates with sepsis: A retrospective case-control study

“…19 Complex CHD was defined as defects requiring surgery before 12 months of age. 20 The duration between sepsis and the onset of NEC was defined as the time from sepsis diagnosis to the onset of NEC. The duration between red blood cell transfusion before NEC and the onset of NEC was defined as the time from last blood transfusion to NEC onset.…”

Uncertainty of Prenatally Diagnosed Congenital Heart Disease: A Qualitative Study

“…[2][3][4][5][6][7] Prenatal diagnosis has been shown to improve parental understanding of CHD at time of neonatal intensive care unit discharge. 8 Yet evidence suggests that receiving a prenatal CHD diagnosis may be psychologically harmful to parents [9][10][11][12][13] or provide no psychological benefit. [14][15][16][17][18][19] Indeed, some parents who receive these diagnoses may experience more stress, anxiety, and depression at hospital discharge and for months after birth.…”

Caregiver experiences of paediatric inpatient cardiac services: A qualitative systematic review

“…Findings inform priorities for early emotional support to manage 'loss', in an aim to develop positive secure attachments and improve wellbeing and quality of life for both caregiver and child. 4,52 Existing literature debates impacting factors of gender, 4,8,51 severity 8,52,53 and timing of diagnosis [54][55][56] on caregiver distress. Our findings revealed comparative narratives across such factors.…”