Prevalence of traumatic psychological stress reactions in children and parents following paediatric surgery: a systematic review and meta-analysis

Abstract

BackgroundChildren undergoing surgery and their parents are at risk of developing post-traumatic stress reactions. We systematically reviewed the literature to understand the prevalence of this issue, as well as potential risk factors.MethodsWe conducted a systematic review and meta-analysis, using PubMed, PsycInfo, Web of Science and Google Scholar, with searches conducted in February 2021. Papers were included if they measured post-traumatic stress in children and/or parents following paediatric surgery and were excluded if they did not use a validated measure of post-traumatic stress. Data were extracted from published reports.FindingsOur search yielded a total of 1672 papers, of which 16 met our inclusion criteria. In meta-analysis, pooled studies of children estimated an overall prevalence of 16% meeting criteria for post-traumatic stress disorder post surgery (N=187, 95% CI 5% to 31%, I2=80%). After pooling studies of parents, overall prevalence was estimated at 23% (N=1444, 95% CI 16% to 31%, I2=91%). Prevalence rates were higher than those reported in the general population. Risk factors reported within studies included length of stay, level of social support and parental mental health.InterpretationThere is consistent evidence of traumatic stress following surgery in childhood which warrants further investigation. Those delivering surgical care to children would benefit from a raised awareness of the potential for post-traumatic stress in their patients and their families, including offering screening and support.

Prevalence and associated factors of post-traumatic stress disorder in parents whose infants have single ventricle heart disease

“…45,46 Like our findings, Turgoose et al did not find significant demographic or clinical factors that predict post-traumatic stress disorder in parents of children with CHD (any type) undergoing bypass. 45 Parents need support and education to help them adapt to the stress and challenge of raising a child with critical CHD. 47,48 Healthcare professionals are in a unique position to have a positive influence on how parents adapt to stressors by recognising symptoms in parents and referring parents to appropriate resources.…”

“…2,4,43 Our study showed that demographic and clinical (medical or surgical) factors such as pre-natal diagnosis, complications, and length of hospital stay did not identify which parents were at greater risk to develop post-traumatic stress disorder symptoms, a finding supported by other studies. 44,45 Measures of anxiety have been associated with elevated post-traumatic stress disorder symptoms in parents of children with CHD. 45,46 Like our findings, Turgoose et al did not find significant demographic or clinical factors that predict post-traumatic stress disorder in parents of children with CHD (any type) undergoing bypass.…”

“…44,45 Measures of anxiety have been associated with elevated post-traumatic stress disorder symptoms in parents of children with CHD. 45,46 Like our findings, Turgoose et al did not find significant demographic or clinical factors that predict post-traumatic stress disorder in parents of children with CHD (any type) undergoing bypass. 45 Parents need support and education to help them adapt to the stress and challenge of raising a child with critical CHD.…”

European study showed that children with congenital anomalies often underwent multiple surgical procedures at different ages across Europe

“…5,6 A systematic review found an increased risk of traumatic psychological stress reactions following paediatric surgery, for both the children and the parents. 7 The European network for surveillance of congenital anomalies (EUROCAT) comprises population-based congenital anomaly registries in 23 countries covering more than 1.7 million (29%) of European births per year. 8 To investigate the survival and morbidity of children with major congenital anomalies, members of the EUROCAT registries initiated the EUROlinkCAT project.…”

“…Neonatal surgery also has an impact on family bonding and the initiation of breastfeeding 5,6 . A systematic review found an increased risk of traumatic psychological stress reactions following paediatric surgery, for both the children and the parents 7 …”