title: Maternal psychological stress after prenatal diagnosis of congenital heart disease.
abstract: OBJECTIVE
  To determine whether prenatal diagnosis of congenital heart disease (CHD) increases maternal stress.
  
  
  METHODS
  Self-report instruments were administered to mothers carrying a fetus with CHD. Domains included: (1) traumatic stress (Impact of Events Scale-Revised); (2) depression (Beck Depression Index II); and (3) anxiety (State-Trait Anxiety Index). Modifiers included: (1) coping skills (COPE Inventory); (2) partner satisfaction (Dyadic Adjustment Scale); and (3) demographics. Multivariate linear regression models were used to assess relationships between stress measures and modifiers.
  
  
  RESULTS
  Fifty-nine mothers (gestational age 27 ± 3 weeks) completed all measures. Clinically important traumatic distress was seen in 39%, depression in 22%, and state anxiety in 31%. Lower partner satisfaction was associated with higher depression (P < .01) and higher anxiety (P < .01). After controlling for partner satisfaction and income, "denial" was most associated with increased traumatic stress, anxiety, and depression (P < .01).
  
  
  CONCLUSIONS
  Posttraumatic stress, depression, and anxiety are common after prenatal diagnosis of CHD. Healthy partner relationships and positive coping mechanisms can act as buffers.
authors.affiliation: Fetal Heart Program at the Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. Rychik@email.chop.edu
authors.forename: Jack
authors.initials: J
authors.lastname: Rychik
authors.forename: Denise D
authors.initials: DD
authors.lastname: Donaghue
authors.forename: Suzanne
authors.initials: S
authors.lastname: Levy
authors.forename: Clara
authors.initials: C
authors.lastname: Fajardo
authors.forename: Jill
authors.initials: J
authors.lastname: Combs
authors.forename: Xuemei
authors.initials: X
authors.lastname: Zhang
authors.forename: Anita
authors.initials: A
authors.lastname: Szwast
authors.forename: Guy S
authors.initials: GS
authors.lastname: Diamond
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology* / Q000523:psychology*; D011296:Prenatal Diagnosis; D013315:Stress, Psychological / Q000209:etiology*