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Marital Happiness And Coping Mechanisms Help Pregnant Moms

Pregnant women commonly develop post-traumatic stress, anxiety, and depression when they learn from prenatal diagnosis that they are carrying a fetus with a congenital heart defect (CHD). The intense stress can be reduced by a healthy relationship with their spouse and positive coping mechanisms, reported experts from the Cardiac Center of the Children's Hospital of Philadelphia in The Journal of Pediatrics.

Jack Rychik, M.D., leading author and medical director of the Fetal Heart Program in the hospital, said:

"Receiving the news of carrying a fetus with a CHD is a stressful event which can potentially influence a mother's anxiety level. Prenatal diagnosis is helpful in that it gives parents time to learn about the defect, review treatment options, plan for necessary interventions and consider their options. While this is intrinsically a stressful time for parents, there has previously been little research on the details of this stress and ways to buffer it."

A total of 59 expectant moms who had a gestational age ranging from 17 to 31.5 weeks and were recruited by nurse coordinations at either the first visit to the Fetal Heart Program or a follow-up visit, were surveyed and then followed through the rest of their pregnancy.

The subjects were planning for a follow-up visit, and all wanted to continue the pregnancy after hearing they were carrying fetuses with severe CHD that needed neonatal evaluation and postnatal surgical or catheter-based intervention within the babies' first 6 months of living.

Traumatic stress, depression, and anxiety were measured using psychological evaluation tools and self-report instruments. The experts also compared partner satisfaction and gathered demographic data.

Results showed: Over 39% of the women were experiencing clinically significant traumatic stress 22% were suffering with depression 31% were experiencing state anxiety The researchers found that lower partner satisfaction and lower income were associated with higher levels of depression, traumatic stress, and anxiety. Denial proved to be the most significant factor contributing to depression when the team controlled for partner satisfaction and income.

Guy S. Diamond, Ph.D., a psychologist at the hospital, explained:

"Prenatal diagnosis of CHD is a traumatic event for many pregnant women. In our study we found that a substantial proportion of mothers exhibited evidence for traumatic stress, with nearly 40 percent exceeding clinical cut-off points for post-traumatic stress disorder."

Even though personal coping skills are important, a more pliable response to the stress of prenatal CHD may be better predicted by partner satisfaction, Diamond pointed out. After discovering that denial may contribute to depression, counseling sessions should now start to focus on this risk factor.

Further studies need to be conducted to confirm that mothers are getting the very best multidisciplinary care. Although it is convenient to know in advance that your child has a CDH, the stress that comes with that information is not as helpful.

"In the future, optimal management strategies to improve outcomes for both mom and fetus will include stress reduction techniques, which should accompany the diagnosis of CHD prior to birth," concluded Rychik.

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