Referral for fetal echocardiography is associated with increased maternal anxiety.
BACKGROUND
Referral for fetal echocardiography (fECHO) is an acute stressor that may induce significant maternal anxiety. To promote good clinical management of expectant mothers in this situation, including adequate screening for possible psychiatric interventions, data are needed regarding the psychosocial functioning of women scheduled for fECHO procedures.


OBJECTIVE
To investigate the association between fECHO and maternal anxiety.


METHODS
Pregnant women answered two questionnaires before first fECHO. The Spielberger State-Trait Anxiety Inventory (STAI) assessed how subjects feel "now" (state) versus how they "usually feel" (trait). Separate state and trait anxiety scores were calculated; scores were compared between the study cohort and a gestational age-matched historical cohort of 31 pregnant women who did not undergo fECHO. A second questionnaire developed by the investigators ascertained pregnancy specific concerns and characteristics.


RESULTS
Forty subjects were enrolled. The mean state score of the fECHO cohort (42.1 +/- 15.1) differed from the historical cohort (32.8 +/- 11.3; p = 0.006); however there was no difference between trait scores (34.7 +/- 10.8 vs. 35.4 +/- 12.8; p = 0.8). A multivariate linear regression model controlling for race and maternal age demonstrated that fECHO was a strong independent predictor of maternal state anxiety score (p = 0.004, beta = 10.4).


CONCLUSIONS
Pregnant women presenting for fECHO report high anxiety levels compared with women not presenting for fECHO. Clinician awareness and sensitivity are recommended and further investigation of modifiers of anxiety in this high risk group should be explored.
Rosenberg
Katherine B
KB
Department of Pediatrics-Cardiology, Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital, New York, NY 10032, USA.
Monk
Catherine
C
Glickstein
Julie S
JS
Levasseur
Stephanie M
SM
Simpson
Lynn L
LL
Kleinman
Charles S
CS
Williams
Ismee A
IA
D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001294:Attitude to Health; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000523:psychology*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000523:psychology*; D006801:Humans; D009035:Mothers / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011594:Psychometrics / Q000706:statistics & numerical data; D012016:Reference Values; D012017:Referral and Consultation; D016216:Ultrasonography, Prenatal / Q000523:psychology*; D055815:Young Adult