BJOG. 2025 Sep 4. doi: 10.1111/1471-0528.18343. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess mental health throughout pregnancy among women with a history of diagnosis of fetal anomaly.

DESIGN: Prospective observational study.

SETTING: Tertiary referral centre for fetal medicine.

POPULATION: Pregnant women with a history of fetal anomaly (study group; n = 75) and women without such a history (comparison group; n = 111). A subgroup of women in the study group (n = 28) participated in two different pregnancies, where the first had a diagnosis of fetal anomaly and the second did not.

METHODS: Women completed the Edinburgh Postnatal Depression Scale (EPDS) and Impact of Events Scale (IES) at four timepoints between gestational age 18 weeks and 36 weeks.

MAIN OUTCOMES: Trajectories of EPDS and IES across time in the study group and comparison group, as well as differences in EPDS and IES in the healthy pregnancy and the pregnancy with a diagnosis of fetal anomaly in the subgroup.

RESULTS: Having a history of previous diagnosis of fetal anomaly was associated with elevated levels of depression and traumatic stress throughout pregnancy, even in healthy pregnancies (e.g., EPDS mean difference = 2.65, 95% CI [1.91, 3.21]). The difference between groups was largest early in pregnancy and decreased with increasing gestational age. Furthermore, women in the subgroup experienced much higher levels of distress in the pregnancy with a diagnosis of fetal anomaly than in their healthy pregnancy (e.g., EPDS mean difference = 8.7, 95% CI [6.40, 11.15]).

CONCLUSION: The results highlight the importance of considering women’s history of fetal anomaly and prenatal loss even in healthy pregnancies.

PMID:40908028 | DOI:10.1111/1471-0528.18343