Diagnosis of congenital malformations during the pregnancy is a difficult theme for families and professionals, and can affects the mental health of pregnant women

By Ana Cristina Barros da Cunha, Universidade Federal do Rio de Janeiro, Instituto de Psicologia, Maternidade-Escola

Researchers from the Laboratório de Estudos, Pesquisa e Intervenção em Desenvolvimento e Saúde (LEPIDS, Study, Research and Intervention on Development and Health – www.lepids.org), at the Maternity School Hospital of Universidade Federal do Rio de Janeiro, published a recent paper on the scientific journal Estudos de Psicologia (Campinas) about the impact of diagnosis of congenital malformations on the mental health of pregnant women during the pregnancy. Based on psychological evaluation and interviews with pregnant women who were attended in the Fetal Medicine Service, it was confirmed that the diagnosis of congenital malformations results a potentially negative emotional state on woman, which is negative to her mental health since the beginning of pregnancy. Also, the professionals who attend these women feel uncomfortable at the moment of diagnosis, that was perceived by pregnant women who participated on the study, as illustrated by this report of a women interviewed: “Receiving the news is bad. Doctors are also sad”. This highlights the importance of diagnosis communication as a important factor in the experience of negative feelings and expectations related to this diagnosis, which can have negative effects on all involved in the pregnancy. The study was conducted with 66 pregnant women from the 1st to 3rd gestational trimester with a confirmed diagnosis of fetal malformation. During the waiting for prenatal care, patients responded to inventories to evaluate symptoms of anxiety and depression, and a questionnaire to investigate aspects of the news and the coping face to diagnosis. Results revealed that all pregnant women had anxiety and 78% reported depressive symptoms, which were present throughout the pregnancy. Although depressive symptoms were slightly higher in the 1st quarter, there was a higher incidence of both conditions when the diagnosis of congenital malformation was communicated in the 2nd trimester of pregnancy. At the end of pregnancy depressive symptoms became equivalent to anxiety. About the perception of diagnostic communication and coping, women, all informed by a doctor, highlighted in the interviews a careful and attentive posture adopted by the professional, as in this report: “The super attentive doctor was very cautious, where she did not say that was 100% of something serious but that diagnosis would be made“. However, as expected, no pregnant woman reported to have had a positive reaction. Reactions of shock and reports as “I was sad, desperate, unsure of anything” were common face to the diagnosis, and also shared by his partners and family. Based on these results, it is concluded that the news of congenital malformation diagnosis should be transmitted warmly, with clear language and objective and accessible information. The impact of bad news can be minimized by the restoring of confidence in the medical care, as well as the acceptance of the fact by partners and family. All these factors are essential to the woman and everyone involved in pregnancy can give new meaning and significance to the experience of pregnancy of malformed baby.

To read the article, access it

CUNHA, A.C.B., et al. Diagnosis of congenital malformations: Impact on the mental health of pregnant women. Estudos de Psicologia (Campinas). 2016, vol. 33, nº 4, pp. 601-611. [viewed 17^th October 2016]. ISSN: 1982-0275. DOI: 10.1590/1982-02752016000400004. Available from: http://ref.scielo.org/x25rwn

External link

Estudos de Psicologia (Campinas) – ESTPSI: <http://www.scielo.br/estpsi>