"The Mental Health Piece is Huge": perspectives on developing a prenatal maternal psychological intervention for congenital heart disease

Authors

Kristina M. Espinosa, Developing Brain Institute, Children's National Hospital, Washington, DC, USA.
Melissa Julian, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA.
Yao Wu, Developing Brain Institute, Children's National Hospital, Washington, DC, USA.
Catherine Lopez, Developing Brain Institute, Children's National Hospital, Washington, DC, USA.
Mary T. Donofrio, Division of Cardiology, Children's National Hospital, Washington, DC, USA.
Anita Krishnan, Division of Cardiology, Children's National Hospital, Washington, DC, USA.
Suma Goudar, Division of Cardiology, Children's National Hospital, Washington, DC, USA.
Stephanie Bowers, Division of Cardiology, Children's National Hospital, Washington, DC, USA.
Scott Douglas-Barnett, Developing Brain Institute, Children's National Hospital, Washington, DC, USA.
Catherine Limperopoulos, Developing Brain Institute, Children's National Hospital, Washington, DC, USA.
Huynh-Nhu Le, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA.

Document Type

Journal Article

Publication Date

8-1-2022

Journal

Cardiology in the young

Volume

32

Issue

8

DOI

10.1017/S1047951121004030

Keywords

Congenital heart disease; maternal intervention; maternal mental health; prenatal diagnosis; psychological stress

Abstract

OBJECTIVES: Women carrying a fetus diagnosed with congenital heart disease often experience significant distress because of their medical diagnosis. Given the well-documented impact associated with elevated prenatal stress and critical importance of developing targeted interventions, this study aims to examine stressors, coping and resilience resources, and mental health treatment preferences in pregnant women receiving a congenital heart disease diagnosis to inform the development of a psychological intervention to reduce maternal distress prenatally. METHODS: Three groups of participants were included consisting of two pregnant women carrying a fetus with congenital heart disease, five women of children (4-16 months) with congenital heart disease, and five paediatric cardiology medical providers. Responses were gathered via semi-structured interviews and analysed using qualitative thematic analysis. RESULTS: Information regarding four broad areas were analysed of emotional distress during pregnancy; experience of initial diagnosis; coping and resilience; and perspectives on a mental health intervention in pregnancy. Anxiety regarding baby's future, guilt following diagnosis, and various coping strategies emerged as primary themes among the participant sample. Medical staff corroborated mothers' heightened anxiety and viewed a psychotherapeutic intervention during the prenatal period as essential and complimentary to standard of care. CONCLUSION: We identified salient themes and preferred components for a future psychological intervention delivered prenatally. PRACTICE IMPLICATIONS: Patients' and providers' perspectives regarding the nature of maternal distress, resilience and treatment preferences can inform the development of interventions to support the emotional well-being of pregnant women carrying a fetus with congenital heart disease to optimise care and potentially improve outcomes for fetal brain development.

APA Citation

Espinosa, Kristina M.; Julian, Melissa; Wu, Yao; Lopez, Catherine; Donofrio, Mary T.; Krishnan, Anita; Goudar, Suma; Bowers, Stephanie; Douglas-Barnett, Scott; Limperopoulos, Catherine; and Le, Huynh-Nhu, ""The Mental Health Piece is Huge": perspectives on developing a prenatal maternal psychological intervention for congenital heart disease" (2022). GW Authored Works. Paper 1539.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1539

Department

Pediatrics