PDF(Pubmed)
Abstract：
BACKGROUND: The decision to terminate a pregnancy due to fetal anomalies can have a significant emotional impact, especially in second-trimester terminations. Previous studies on the psychological consequences of pregnancy termination have had limitations, and little is known about the outcomes for partners and the impact of fetal donation. Therefore, we aimed to investigate the psychological effects of second-trimester pregnancy termination and identify factors associated with outcomes in both women and men, including donation of fetal remains to science.
METHODS: A longitudinal cohort study was conducted at the Amsterdam UMC in the Netherlands, involving women and partners who underwent termination at or before 23 weeks and 6 days of gestation. Questionnaires were administered at termination, 6 weeks, and 4 months after. We utilized validated questionnaires to assess psychological morbidity (grief, post-traumatic stress and postnatal depression and quality of life [QoL]), and factors that could potentially influence outcomes.
RESULTS: Of 241 participants, women displayed more pronounced psychological distress than men, though both groups improved over time. Four months after termination, 27.4% of women and 9.1% of men showed signs of pathological grief. Scores indicative for postnatal depression occurred in 19.8% women and 4.1% of men. A prior psychiatric history was a consistent predictor of poorer outcomes. Fetal donation to the Dutch Fetal Biobank was associated with reduced likelihood of symptoms of complicated grief four months after termination.
CONCLUSIONS: Second-trimester termination of pregnancy for fetal anomalies can lead to psychological morbidity, particularly in women. However, there is a notable improvement over time for both groups. Individuals with prior psychiatric history appear more vulnerable post-termination. Also, fetal donation to science did not have a negative impact on psychological well-being.
METHODS: A longitudinal cohort study was conducted at the Amsterdam UMC in the Netherlands, involving women and partners who underwent termination at or before 23 weeks and 6 days of gestation. Questionnaires were administered at termination, 6 weeks, and 4 months after. We utilized validated questionnaires to assess psychological morbidity (grief, post-traumatic stress and postnatal depression and quality of life [QoL]), and factors that could potentially influence outcomes.
RESULTS: Of 241 participants, women displayed more pronounced psychological distress than men, though both groups improved over time. Four months after termination, 27.4% of women and 9.1% of men showed signs of pathological grief. Scores indicative for postnatal depression occurred in 19.8% women and 4.1% of men. A prior psychiatric history was a consistent predictor of poorer outcomes. Fetal donation to the Dutch Fetal Biobank was associated with reduced likelihood of symptoms of complicated grief four months after termination.
CONCLUSIONS: Second-trimester termination of pregnancy for fetal anomalies can lead to psychological morbidity, particularly in women. However, there is a notable improvement over time for both groups. Individuals with prior psychiatric history appear more vulnerable post-termination. Also, fetal donation to science did not have a negative impact on psychological well-being.
摘要：
背景：由于胎儿异常而决定终止妊娠可能会产生重大的情绪影响，尤其是在妊娠中期。以前关于终止妊娠的心理后果的研究有局限性，对伴侣的结局和胎儿捐献的影响知之甚少。因此,我们旨在调查终止中期妊娠的心理影响，并确定与女性和男性结局相关的因素。包括将胎儿遗体捐献给科学.
方法：在荷兰阿姆斯特丹UMC进行了一项纵向队列研究，涉及在妊娠23周和6天或之前终止妊娠的妇女和伴侣。在终止时进行问卷调查，6周,4个月后。我们利用经过验证的问卷来评估心理发病率(悲伤，创伤后应激和产后抑郁和生活质量[QoL])，以及可能影响结果的因素。
结果：在241名参与者中，女性比男性表现出更明显的心理困扰，虽然两组都随着时间的推移而改善。终止合同四个月后,27.4%的女性和9.1%的男性表现出病理性悲伤的迹象。19.8％的女性和4.1％的男性发生了产后抑郁症的得分。既往精神病史是预后较差的一致预测因素。向荷兰胎儿生物库捐赠胎儿与终止后四个月出现复杂悲伤症状的可能性降低有关。
结论：妊娠中期因胎儿畸形而终止妊娠可导致心理并发症，尤其是女性。然而,随着时间的推移，两组都有显著的改善。有精神病史的人在终止后似乎更容易受到伤害。此外，向科学捐赠胎儿对心理健康没有负面影响。
方法：在荷兰阿姆斯特丹UMC进行了一项纵向队列研究，涉及在妊娠23周和6天或之前终止妊娠的妇女和伴侣。在终止时进行问卷调查，6周,4个月后。我们利用经过验证的问卷来评估心理发病率(悲伤，创伤后应激和产后抑郁和生活质量[QoL])，以及可能影响结果的因素。
结果：在241名参与者中，女性比男性表现出更明显的心理困扰，虽然两组都随着时间的推移而改善。终止合同四个月后,27.4%的女性和9.1%的男性表现出病理性悲伤的迹象。19.8％的女性和4.1％的男性发生了产后抑郁症的得分。既往精神病史是预后较差的一致预测因素。向荷兰胎儿生物库捐赠胎儿与终止后四个月出现复杂悲伤症状的可能性降低有关。
结论：妊娠中期因胎儿畸形而终止妊娠可导致心理并发症，尤其是女性。然而,随着时间的推移，两组都有显著的改善。有精神病史的人在终止后似乎更容易受到伤害。此外，向科学捐赠胎儿对心理健康没有负面影响。
