Bekkhus M, Oftedal A, Haugen G, Mortensen B, Kaasen A. Acute symptoms of depression and traumatic stress in men and women who terminate pregnancy after the detection of fetal anomaly: A prospective observational study.
BJOG 2024. [PMID:
38899436 DOI:
10.1111/1471-0528.17884]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 05/28/2024] [Accepted: 06/02/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE
To assess acute and long-term stress in men and women after the detection of fetal anomalies leading to pregnancy termination.
DESIGN
Prospective observational study.
SETTING
Tertiary referral centre for fetal medicine.
POPULATION
From the initial sample of 180 pregnant women with a fetal anomaly detected by ultrasound examination, a total of 87 women terminated their pregnancy, with 72 partners included in the sample. At the time of detection, the group of women (n = 93) and their partners (n = 81) who did not terminate the pregnancy following a diagnosis were included as a comparison group.
METHODS
These women and their partners were asked to complete the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Events Scale (IES) questionnaires, both at the time of initial detection and at 6 weeks after the termination of the pregnancy.
MAIN OUTCOME MEASURES
Responses to the EPDS and the IES at the time of initial detection and at 6 weeks after pregnancy termination.
RESULTS
Women who underwent pregnancy termination reported higher symptom levels of depression, but not traumatic stress, prior to the termination than women who chose not to terminate their pregnancy. Among men, there was a difference across depression and all subscales of traumatic stress (e.g. IES intrusion: mean difference 5.31; 95% CI 2.32-8.31). Women experienced more depressive symptoms over time than men (β = 4.33, P < 0.001) and higher symptom levels on all subscales of traumatic stress (e.g. IES intrusion: β = 5.27; P < 0.001).
CONCLUSIONS
Overall, our study underscores the heightened levels of depression and traumatic stress experienced by prospective parents, particularly prior to the decision to terminate a pregnancy following the detection of a fetal anomaly. Although women generally report more pronounced symptoms, it is noteworthy that men also experience considerable traumatic stress during this challenging time.
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