Prenatal diagnosis of congenital malformations and parental psychological distress--a prospective longitudinal cohort study.
OBJECTIVE
To test whether postnatal psychological distress in parents of babies with congenital malformations is reduced by prenatal diagnosis.


METHODS
A prospective observational longitudinal cohort study was conducted at two Norwegian hospitals. We included 293 parents of babies with congenital malformations (prenatal detection rate: 36.5%) referred for neonatal surgery and 249 parents of healthy babies (comparison group). Parental psychological responses were assessed on three postnatal occasions by psychometric instruments (GHQ-28, STAI-X1, and IES).


RESULTS
Significantly increased psychological distress (GHQ-28) was reported by parents who received prenatal diagnosis as compared to postnatal diagnosis; acutely 28.9 versus 24.4, P = 0.006 (comparison group: 19.6); at 6 weeks 26.8 versus 21.5, P < 0.001 (comparison group: 17.7); and at 6 months 22.6 versus 18.7, P = 0.015 (comparison group: 16.6). Mothers consistently reported higher levels of distress than fathers. Multiple linear regression analysis showed that prenatal diagnosis and being a mother significantly predicted severity of acute psychological distress. At 6 weeks and 6 months, mortality and associated anomalies were significant independent predictors of psychological distress.


CONCLUSIONS
Controlling for other covariates, we found that prenatal diagnosis of congenital malformations was a significant independent predictor of acute parental psychological distress after birth.
Skari
H
H
Department of Pediatric Surgery, Rikshospitalet University Hospital, Oslo, Norway.
Malt
U F
UF
Bjornland
K
K
Egeland
T
T
Haugen
G
G
Skreden
M
M
Dalholt Björk
M
M
Bjornstad Ostensen
A
A
Emblem
R
R
D000328:Adult; D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009035:Mothers / Q000523:psychology; D010290:Parents / Q000523:psychology*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000523:psychology*; D011446:Prospective Studies; D011581:Psychological Tests; D013315:Stress, Psychological / Q000453:epidemiology*