EFFECTS OF PREVIOUS PREGNANCY LOSS ON LEVEL OF MATERNAL ANXIETY AFTER PRENATAL ULTRASOUND SCREENING FOR FETAL MALFORMATION

ABSTRACT

The impact of previous stillbirth, miscarriage, or preterm delivery on anxiety in pregnant women in various subgroups at high risk for fetal abnormality in comparison with a nonrisk control group of women with healthy uncomplicated pregnancies was studied longitudinally. The level of anxiety in women (n = 674) during early pregnancy was assessed by questionnaire. Data were collected at three points in time: immediately before the ultrasound scanning, at 5–6 weeks, and at 10–12 weeks after the prenatal examination for fetal malformation. In general, all women with high-risk pregnancies (n = 506) showed high levels of anxiety immediately before ultrasound scanning. There was a significant decrease in anxiety over the following 10–12 weeks. By contrast, level of anxiety was not raised in the no-risk control group (n = 168). However, pregnant women who had experienced miscarriage or stillbirth in previous pregnancies showed increasing or persistently high levels of anxiety over time. We believe it is very important to screen women whose levels of anxiety are consistently high or escalating and to offer psychotherapeutic counseling as a means of preventing pregnancy complications.

Abstract

Karl Heinz Brisch, is head of the Department of Pediatric Psychosomatic Medicine and Psychotherapy at the Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany. He is a child and adolescent psychiatrist, psychiatrist, and neurologist specializing in psychosomatic medicine. His main research areas include parent-infant interaction, attachment, coping with high-tech medicine, and diagnosis and treatment of attachment disorders.

Abstract

Dorothee Munz, is a psychologist, researcher, and psychotherapist in the Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany. Her research areas include issues of coping with diagnostic procedures in medicine and psychotherapy.

Abstract

Horst Kächele, chair and director of the Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany, is a psychoanalyst and psychotherapist. His research fields are psychotherapy process and outcome research, psychosocial aspects of bone marrow transplantation, eating disorders and clinical attachment research.

Abstract

Rainer Terinde, head of the Subdepartment of Prenatal Diagnosis and Sonography in Gynecology, Women's Hospital, University of Ulm, Ulm, Germany, is a gynecologist and obstetrician with specialization in prenatal diagnosis. His research areas are doppler sonography in pregnancy, laser coagulation in twin to twin transfusion syndrome, and diagnosis and treatment in high-risk pregnancies.

Abstract

Rolf Kreienberg, director of the Women's Hospital, University of Ulm, Ulm, Germany, is a gynecologist and obstetrician specializing in oncology.

The research in this article was made possible by a grant from the German Research Council to H. Kächele, R. Kreienberg, R. Terinde, and K. H. Brisch (Grant KA 483/1-1, 1-2). Further grants from the University of Ulm and from the Kässbohrer-Stiftung (Germany) to K. H. Brisch supported this study. We are most grateful for this support. We are also indebted to the pregnant women for their generous longitudinal cooperation with the study, and to R. Terinde's team of co-workers who, with great interest and commitment, supported the recruitment of the sample