Maternal emotional wellbeing over time and attachment to the fetus when a malformation is detected

Abstract

Objectives: To explore women's emotional wellbeing and attachment to the fetus when informed during pregnancy of a fetal malformation.

Methods: In a longitudinal community-based study, 56 pregnant women with a detected fetal malformation and continued pregnancy were invited to complete questionnaires in mid-pregnancy, two months postpartum and one year postpartum. The questionnaire included the Edinburgh Postnatal Depression Scale, the Cambridge Worry Scale, the State-Trait Anxiety Inventory, and the Maternal-Fetal Attachment Scale. Socio-demographics and obstetric background data were also collected. Descriptive statistical analyses were performed.

Results: Approximately 84% returned the questionnaires and 37% of women in mid-pregnancy, 26.5% two months postpartum and 22% one year postpartum were found to have depressive symptoms. In mid-pregnancy 8.9% had thoughts of harming themselves, and almost all reported at least one major worry. Worry about the relationship with their husband or partner increased two months postpartum and one year postpartum. The means of both state and trait anxiety levels were high on all three measuring occasions and the mean score for maternal-fetal attachment was 3.7 (SD 0.67), indicating a high level of attachment.

Conclusion: The results highlight the importance of adequate support when fetal malformations are detected on ultrasound examination.

Keywords: Emotional wellbeing; Fetal malformation; Maternal–fetal attachment; Postnatal depression; Ultrasound screening.