Abstract
Prenatal ultrasonographic detection of fetal structural anomaly may adversely affect maternal mental health throughout pregnancy, particularly in the current COVID-19 pandemic. This study aims to prospectively assess maternal stress, anxiety, and depression following ultrasonographic detection of fetal structural anomaly from diagnosis until delivery during the COVID-19 pandemic. A total of 141 pregnant women at a tertiary hospital who underwent detailed scans between 16 and 24 gestational weeks were included and categorized into the study (anomaly finding, n = 65) and comparison (normal finding, n = 76) groups. Self-administered questionnaires of 10-item Perceived Stress Scale (PSS-10) and Hospital Anxiety and Depression Scale (HADS) were used to assess maternal stress, anxiety, and depression at prior detection (T1), two-to-four weeks post-detection (T2), one-to-two weeks prior to delivery (T3), and one-to-two weeks post-delivery (T4). Repeated measures of analysis of variance (ANOVA) were conducted to assess time-, between-group, and time–group interaction effect. In general, maternal stress improved, but anxiety worsened, while depression persisted, over the time from T1 to T4. The average maternal stress and anxiety levels were significantly higher among groups with fetal anomaly. The maternal stress and anxiety level were significantly affected within one-to-two weeks post-detection of fetal structural anomaly. In conclusion, maternal mental health parameters were affected differently during the COVID-19 pandemic, with higher vulnerability of stress and anxiety among pregnant women with fetal structural anomaly particularly within one-to-two weeks post-detection.
Highlights
Maternal mental health disorders are the commonest illness related to pregnancy with considerable adverse impacts against mother, fetus/children, and economy [1]
Notwithstanding, pregnant women are still considered therapeutic orphans [12], and they must be mainstreamed into healthcare research and practice, more so during this era of the COVID-19 pandemic [12,13]
It has been reported that 22.4% of pregnant women perceived that their antenatal appointments were affected, 34.7% felt anxious when their spouse was not allowed to accompany during antenatal visit, 20.7% were worried about having to give birth during the lockdown, 23.6% received unclear advice on where to deliver, and 19.8% felt worried that their spouse cannot accompany them during childbirth [27]. This current study focuses on the mental health following ultrasonographic detection of fetal structural anomaly during the COVID-19 pandemic
Summary
Maternal mental health disorders are the commonest illness related to pregnancy with considerable adverse impacts against mother, fetus/children, and economy [1]. The prevalence of antenatal and postnatal anxiety disorder has been reported at. Maternal mental health disorders might be under-detected and/or under-treated during pregnancy [1,6,7,8]. History taking on mental health such as anxiety about outcome of pregnancy is not usually explored during visit [9]. These under-detected and under-treated issues are critical as early psychological and psychosocial interventions have been shown to be effective and cost-effective [10,11]. Notwithstanding, pregnant women are still considered therapeutic orphans [12], and they must be mainstreamed into healthcare research and practice, more so during this era of the COVID-19 pandemic [12,13]
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