Depression, anxiety, and mental health service experiences of women with a twin-twin transfusion syndrome pregnancy.

Symptoms of emotional distress during and after pregnancy may be introduced or exacerbated by unexpected medical conditions in the mother or fetus. Twin-twin transfusion syndrome (TTTS), which accounts for 17% of fetal deaths in twins and entails substantial medical uncertainty, may represent a particularly challenging pregnancy experience. Yet, little is known about the impact of TTTS on women's emotional health. We retrospectively surveyed 350 women who experienced a TTTS pregnancy about their experiences at three time points (prior to, during, and after pregnancy) to examine symptoms of anxiety and depression, mental health diagnoses, thoughts of seeking mental healthcare, help received, and preferred mental health services. Women in this study experienced significantly elevated symptoms of depression and anxiety during and after pregnancy, regardless of their pregnancy outcome (double survivor, single survivor, or double loss). Women reported feeling devastated by their experience and indicated they would have accepted mental healthcare had it been offered and had barriers to care been addressed. Prospective studies of women experiencing TTTS pregnancies are needed to examine TTTS effects on maternal mental health and to determine how to best address emotional care needs.