Impact of Transfer of Maternal Care for Fetal Anomalies on Maternal Depression and Anxiety Screening: A Prospective Cohort at a Tertiary Care Center.

Autor:	Buskmiller C; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Greenwood LA; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Alpuing Radilla LA; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Lane K; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Gray LL; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Ivey RT; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Carrol MR; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Munoz JL; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Sanz Cortes M; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Nassr AA; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Belfort MA; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Horst K; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA., Donepudi RV; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas, USA.
Jazyk:	angličtina
Zdroj:	Fetal diagnosis and therapy [Fetal Diagn Ther] 2023; Vol. 50 (4), pp. 282-288. Date of Electronic Publication: 2023 Jun 05.
DOI:	10.1159/000531180
Abstrakt:	Introduction: Perinatal depression and anxiety are major causes of maternal morbidity, and are more common in high-risk pregnancies compared to low-risk pregnancies. This study used validated screening tools to assess the prevalence of depression and anxiety symptoms in pregnant patients who transferred their obstetric care to a specialized fetal center for fetal anomaly. Methods: This is a prospective cohort of patients with a fetal anomaly prompting transfer of obstetric care to Texas Children's Hospital Fetal Center between January 2021 and February 2022. The primary outcome was a self-assessed Edinburgh Postnatal Depression Scale score of 13 or higher, either antepartum or postpartum ("ever-positive EPDS"). Secondary outcomes included self-assessed Perinatal Anxiety Screening Scale (PASS) scores of 21 or higher ("ever-positive PASS"), obstetric outcomes, and neonatal outcomes. A frequentist analysis was performed. Results: Of 149 women who transferred to Texas Children's Hospital during the study period, 94 enrolled in this study. Twenty-six percent of women had an ever-positive EPDS; 20% of patients had an ever-positive PASS. Patients were more likely to have an ever-positive EPDS if they were single (46% compared to 20%, p = 0.025). Women who had an ever-positive EPDS were more likely to be referred to psychiatry (46% compared to 14%, p = 0.004) and psychotherapy (29% compared to 1%, p < 0.001). Surprisingly, patients were more likely to have an ever-positive PASS if they reported good social support (p = 0.03). Antepartum EPDS and PASS scores had no relationship with postpartum EPDS scores. Conclusion: Women who transfer care to a tertiary setting have positive EPDS scores at double the rate of the general population, but tend to experience this either antepartum or postpartum (not both). Fetal centers should be prepared to screen for mental health symptoms before and after delivery and provide appropriate referral or treatment. (© 2023 S. Karger AG, Basel.)
Databáze:	MEDLINE
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