Key result
Fetal echocardiography referral is linked to ~10-point higher maternal state anxiety scores.
Why the study?
Referral for fetal echocardiography is an acute stressor that may induce significant maternal anxiety, but data on psychosocial functioning in this context are needed to guide clinical management.
Does referral for fetal echocardiography increase maternal anxiety in pregnant women?
Cohort (n=71)
Does referral for fetal echocardiography increase maternal anxiety in pregnant women?
Mean Difference: 10.4
Absolute Event Rate: 42.1% vs 32.8%
p-value: p=0.004
Referral for fetal echocardiography is associated with significantly increased maternal state anxiety, suggesting a need for clinician sensitivity and potential psychosocial screening.
fECHO referral may associate with maternal anxiety; leaves open clinical relevance and need for longitudinal studies before screening recommendations.
BACKGROUND: Referral for fetal echocardiography (fECHO) is an acute stressor that may induce significant maternal anxiety. To promote good clinical management of expectant mothers in this situation, including adequate screening for possible psychiatric interventions, data are needed regarding the psychosocial functioning of women scheduled for fECHO procedures. OBJECTIVE: To investigate the association between fECHO and maternal anxiety. METHODS: Pregnant women answered two questionnaires before first fECHO. The Spielberger State-Trait Anxiety Inventory (STAI) assessed how subjects feel "now" (state) versus how they "usually feel" (trait). Separate state and trait anxiety scores were calculated; scores were compared between the study cohort and a gestational age-matched historical cohort of 31 pregnant women who did not undergo fECHO. A second questionnaire developed by the investigators ascertained pregnancy specific concerns and characteristics. RESULTS: Forty subjects were enrolled. The mean state score of the fECHO cohort (42.1 +/- 15.1) differed from the historical cohort (32.8 +/- 11.3; p = 0.006); however there was no difference between trait scores (34.7 +/- 10.8 vs. 35.4 +/- 12.8; p = 0.8). A multivariate linear regression model controlling for race and maternal age demonstrated that fECHO was a strong independent predictor of maternal state anxiety score (p = 0.004, beta = 10.4). CONCLUSIONS: Pregnant women presenting for fECHO report high anxiety levels compared with women not presenting for fECHO. Clinician awareness and sensitivity are recommended and further investigation of modifiers of anxiety in this high risk group should be explored.
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Rosenberg et al. (2010) conducted a cohort in Pregnancy (n=71). Referral for fetal echocardiography vs. No referral for fetal echocardiography (historical cohort) was evaluated on Maternal state anxiety score (beta = 10.4, p=0.004). Referral for fetal echocardiography was an independent predictor of higher maternal state anxiety scores compared to pregnant women not referred for the procedure (adjusted beta = 10.4; p=0.004).
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