The impact of our images: psychological implications in expectant parents after a prenatal diagnosis
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FETAL IMAGING
The impact of our images: psychological implications in expectant parents after a prenatal diagnosis Christina Paidas Teefey 1 & Jessica Hertzog 1 & Elizabeth D. Morris 1 & Julie S. Moldenhauer 1 & Joanna C. M. Cole 1 Received: 18 November 2019 / Revised: 30 April 2020 / Accepted: 1 July 2020 / Published online: 19 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Parents are at heightened risk for perinatal depression, anxiety and traumatic stress after receiving a prenatal diagnosis of a congenital anomaly. Identifying patients at risk and implementing effective support is crucial to optimizing care in this vulnerable population. A multidisciplinary care team with embedded psychosocial support services can be utilized to evaluate and address the needs of pregnant women and their families, not only at the time of diagnosis, but throughout the course of the pregnancy and postpartum period. Provider awareness helps to facilitate expedited referral to psychosocial services to provide comprehensive care to the patient and family unit. Keywords Fetus . Mental health screening . Perinatal mood and anxiety disorders . Perinatal psychological risk . Pregnancy . Prenatal diagnosis . Psychosocial risk . Traumatic stress
Introduction Congenital anomalies affect approximately 3% of neonates and account for 20% of infant mortality [1, 2]. The identification of a fetal abnormality often leads to a change in prenatal care from the anticipated routine care to a more intensive plan that involves frequent imaging and antenatal surveillance, invasive diagnostics such as amniocentesis, specialized delivery planning, and an increased risk for stillbirth in some cases. Furthermore, certain conditions warrant surgical intervention before or after birth, and frequently families experience a prolonged stay in the neonatal intensive care unit (NICU). Expectant parents are at heightened risk for perinatal depression, anxiety and traumatic stress after a diagnosis of an anomaly in pregnancy [3, 4]. This article highlights relevant studies that focus on the psychological impact of a prenatal imaging diagnosis, the importance of mental health screening, and the role of a collaborative care model to provide additional support in this high-risk population.
* Christina Paidas Teefey [email protected] 1
Center for Fetal Diagnosis and Treatment, Children’s Hospital of Philadelphia, Perelman School of Medicine, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA
A wide variety of screening tools are used to detect psychological risk during the perinatal period. Studies have found an increased risk of maternal anxiety, depression and traumatic stress after a fetal diagnosis is confirmed [5–8]. Kaasen et al. [6] assessed the psychological response among women with a confirmed prenatal diagnosis of a fetal structural anomaly on ultrasound imaging compared to those with an unremarkable imaging. Self-reported questionnaires were used to assess social dysfunction, health perception and psycho
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