J Kemp1, M Davenport, A Pernet. 1. Department of Paediatric Surgery, King's College Hospital, London, England.
Abstract
BACKGROUND: Increasing numbers of infants have the diagnosis of a surgical malformation made before birth. This allows (1) fetal intervention, (2) in utero transfer and planned delivery in a surgical center, and (3) antenatal counseling of likely prognosis and outcome. The aim of this study was to assess the effectiveness of antenatal counseling in terms of the parental psychological response. METHODS: Antenatal counseling by a pediatric surgeon and neonatal nurse was given after ultrasound diagnosis of a fetal surgical malformation (eg, gastroschisis, diaphragmatic hernia). Anxiety levels were measured using the Spielberger State-Trait Anxiety Inventory, a tool used by psychologists to assess the inherent level of anxiety, or Trait anxiety (STAI-T), and the current level of anxiety, or State anxiety (STAI-S). RESULTS: Fifty six prospective mothers filled out Spielberger questionnaires (subjects, n = 26; controls, n = 30). Nineteen subjects' partners also completed questionnaires. There was no significant difference in Trait anxiety scores between subjects and controls (41 [interquartile range, 30 to 511 v 38.5 [range, 32 to 47]; P = .58). There was no significant correlation between maternal and paternal Trait anxiety (P = .11). There was a significant reduction in State anxiety scores in both subject mothers (49.5 [interquartile range, 27 to 73) v38 [range, 31 to 49]; P = .01) and fathers (47 [interquartile range, 36 to 55] v 37 [interquartile range, 32 to 49]; P = .006) after pediatric surgical consultation. CONCLUSION: Counseling by specialist staff reduced levels of parental anxiety associated with the diagnosis of fetal surgical malformation.
BACKGROUND: Increasing numbers of infants have the diagnosis of a surgical malformation made before birth. This allows (1) fetal intervention, (2) in utero transfer and planned delivery in a surgical center, and (3) antenatal counseling of likely prognosis and outcome. The aim of this study was to assess the effectiveness of antenatal counseling in terms of the parental psychological response. METHODS: Antenatal counseling by a pediatric surgeon and neonatal nurse was given after ultrasound diagnosis of a fetal surgical malformation (eg, gastroschisis, diaphragmatic hernia). Anxiety levels were measured using the Spielberger State-Trait Anxiety Inventory, a tool used by psychologists to assess the inherent level of anxiety, or Trait anxiety (STAI-T), and the current level of anxiety, or State anxiety (STAI-S). RESULTS: Fifty six prospective mothers filled out Spielberger questionnaires (subjects, n = 26; controls, n = 30). Nineteen subjects' partners also completed questionnaires. There was no significant difference in Trait anxiety scores between subjects and controls (41 [interquartile range, 30 to 511 v 38.5 [range, 32 to 47]; P = .58). There was no significant correlation between maternal and paternal Trait anxiety (P = .11). There was a significant reduction in State anxiety scores in both subject mothers (49.5 [interquartile range, 27 to 73) v38 [range, 31 to 49]; P = .01) and fathers (47 [interquartile range, 36 to 55] v 37 [interquartile range, 32 to 49]; P = .006) after pediatric surgical consultation. CONCLUSION: Counseling by specialist staff reduced levels of parental anxiety associated with the diagnosis of fetal surgical malformation.