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. 2022 Jun 15;14(12):2945.
doi: 10.3390/cancers14122945.

Psychological Impact of TP53-Variant-Carrier Newborns and Counselling on Mothers: A Pediatric Surveillance Cohort

Amanda Scartezini Gozdziejewski  1   2 , Clarice Wichinescki Zotti  1   2 , Isabela Aparecida Moreira de Carvalho  2 , Thairine Camargo Dos Santos  2 , Luana Rayana de Santi Walter  2 , Karin Rosa Persegona Ogradowski  1   2 , Karin Luiza Dammski  1 , Heloisa Komechen  1   3 , Monalisa Castilho Mendes  1   3 , Emanuelle Nunes de Souza  1   3 , Mariana Martins Paraizo  1 , Ivy Zortea da Silva Parise  1   3 , Guilherme Augusto Parise  1   3 , André Luiz Grion  1 , Gislaine Custódio  3 , Rosiane Guetter Mello  1   2 , Bonald C Figueiredo  1   2   3
Affiliations

Psychological Impact of TP53-Variant-Carrier Newborns and Counselling on Mothers: A Pediatric Surveillance Cohort

Amanda Scartezini Gozdziejewski et al. Cancers (Basel). .

Abstract

Counselling and genetic testing (CGT) after neonatal screening may increase depression and anxiety (DA) levels during cancer surveillance. This study assessed the DA scores in mothers of newborns from Paraná state, Southern Brazil, carrying the TP53 p.R337H variant. To understand and adjust DA conditions during term of pregnancy, we initially detected sociodemographic covariates [marital status (MS), number of children (NC), and/or education level (EL): MS-NC-EL] on an independent group of pregnant women (not subjected to genetic testing). The Hospital Anxiety and Depression Scale (HADS) was used to assess risk factors in pregnant (cross-sectional analysis) and unrelated mothers (at 2-month intervals, longitudinal study) of TP53 p.R337H-tested newborns (three sessions of HADS analysis) using Wilcoxon (Mann-Whitney) and Kruskal-Wallis nonparametric tests. Lower anxiety levels were observed in mothers of noncarriers (without MS-NC-EL = 6.91 ± 1.19; with MS-NC-EL = 6.82 ± 0.93) than in mothers of p.R337H carriers in the first session (without MS-NC-EL = 6.82 = 8.49 ± 0.6025, with MS-NC-EL = 6.82 = 9.21 ± 0.66). The anxiety levels significantly decreased 4 months after CGT (third session) in mothers of p.R337H carriers. We did not find a significant change in depression scores. Mothers with mental health instability requiring medications need periodical psychological support during and after CGT.

Keywords: TP53 p.R337H mutation; anxiety; depression; genetic counselling; predictive testing.

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Conflict of interest statement

The authors declare no conflict of interest with respect to the research, authorship, and publication of this article.

Figures

Figure 1
Figure 1
Study design flowchart. After precounselling and the genetic test on newborns at the hospital by trained nurses, parents of experimental groups were invited (1–2 weeks after birth) to obtain test results and receive counselling, wherein a second DNA test was conducted on their newborns to confirm TP53 p.R337H. After result disclosure of the newborn’s first test, finger (parents) and heel prick (newborn) blood drop sampling, counselling, and education of parents about signs and symptoms of pediatric cancer, the parents were invited for three HADS tests at 2-month intervals. The timeline of clinical and psychological protocols was monitored by telephone. Control group mothers (C1 and C2) who received a negative result for the TP53 p.R337H in their newborns were recruited and assessed by telephone.
Figure 2
Figure 2
HADS-A (anxiety) score in mothers of noncarrier (control group) and carrier newborns (experimental group). Detected risk factors in pregnant women were considered (bias groups, C2, and E2). p-values with Bonferroni correction are shown between the groups (horizontal lines).
Figure 3
Figure 3
HADS-D (depression) score in mothers of noncarrier (control group) and carrier newborns (experimental group). Detected risk factors in pregnant women were considered (groups with any sociodemographic covariate, C2 and E2). p-values with Bonferroni correction are shown between the groups (horizontal lines).
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