Key result
Higher prenatal stress in critical CHD correlates with post-bypass exogenous corticosteroid need.
Why the study?
Prenatal diagnosis of critical CHD causes parental stress that may compound maternal stress, but the relationship between prenatal stress and neonatal postoperative outcomes needed investigation.
Does higher prenatal stress correlate with worse neonatal postoperative outcomes in pregnancies with prenatally diagnosed critical CHD?
Cohort
Does higher prenatal stress correlate with worse neonatal postoperative outcomes in pregnancies with prenatally diagnosed critical CHD?
p-value: p=0.01
Higher prenatal stress in pregnancies complicated by critical CHD correlates with an increased need for post-bypass exogenous corticosteroid treatment in neonates.
Higher prenatal stress scores associated with greater postoperative steroid need in critical CHD; hypothesis-generating for stress mitigation, requiring prospective trials before practice change.
INTRODUCTION: The prenatal diagnosis of congenital heart disease (CHD) is a traumatic event that can cause expectant parents to experience anxiety, depression, and toxic stress. Prenatal exposure to stress may impact neonatal postoperative outcomes. In addition, expectant parents may have other psychosocial stressors that may compound maternal stress. We investigated the relationship between stress in pregnancies complicated by prenatally diagnosed CHD and their neonatal outcomes. METHODS: A pilot retrospective cohort study of pregnancies with prenatally diagnosed critical CHD (2019-2021) was performed. The collected data included pregnancy characteristics and neonatal and postoperative outcomes (including the need for exogenous corticosteroid treatment (ECT)). In order to quantify prenatal stressors, a composite prenatal stress score (PSS) was established and utilized. RESULTS: = 0.01). PSS did not correlate with birthweight, infection, or hypoglycemia in the neonatal period. CONCLUSIONS: Prenatal stress is multifactorial; higher PSS is correlates with post-bypass ECT, suggesting that a stressful intrauterine environment may be associated with worse neonatal postoperative outcomes.
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Ronai et al. (2023) conducted a cohort in Critical congenital heart disease. Prenatal stress (composite prenatal stress score) was evaluated on Neonatal and postoperative outcomes including need for exogenous corticosteroid treatment (p=0.01). Higher composite prenatal stress scores in pregnancies with critical congenital heart disease correlated with the need for post-bypass exogenous corticosteroid treatment (P=0.01).
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