Depressive reactions and stress related to prenatal medicine procedures.
OBJECTIVE
The experience of pregnancy is mainly influenced by the availability of prenatal screening procedures. Previous screening studies focus on somatic abnormalities. The psychological experience of the parents-to-be recedes into the background. The purpose of the present study was to analyze the emotional mood of pregnant women and their partners before and their psychological stress before and after different prenatal screening procedures (ultrasound, chorionic villus sampling or amniocentesis).


METHODS
In the study, 140 pregnant women, and, in 108 cases, their partners, were asked to complete questionnaires before and immediately after the prenatal testing. Depending on the applied prenatal procedure, the subjects were assigned to: the invasive group (amniocentesis or chorionic villus sampling) and the noninvasive group (ultrasound group). We used the German version of the Centre for Epidemiological Studies-Depression Scale of Hautzinger and the short questionnaire of actual situative perceived stress of Müller.


RESULTS
Before the prenatal examination, the mean level of depression of pregnant women was the highest in the noninvasive group compared to the invasive group, although the between-group difference was not significant. However, for their male partners, the mean level of depression was significantly different between the noninvasive and the invasive groups. Furthermore, women undergoing invasive diagnostic or noninvasive diagnostic procedures were significantly more depressed than their partners. The analysis of the actual stress ratings showed a significant reduction from the prescreening to the postscreening stress for pregnant women and their partners in both groups.


CONCLUSIONS
This study reveals that the individual experience of prenatal diagnosis is not determined by the invasiveness of the procedure. Immediate visual presentation of the fetus and confirmation of a normal test result reduce stress that has previously been induced by the prenatal test itself. This contradiction should be discussed with the parents.
Kowalcek
I
I
Division of Prenatal Medicine, Department of Obstetrics and Gynaecology, Medical University of Lübeck, Germany. Kowalcek@t-online.de
Mühlhoff
A
A
Bachmann
S
S
Gembruch
U
U
D000328:Adult; D000649:Amniocentesis / Q000523:psychology*; D015193:Chorionic Villi Sampling / Q000523:psychology*; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D013315:Stress, Psychological / Q000209:etiology*; D016216:Ultrasonography, Prenatal / Q000523:psychology*