目的:胎儿畸形发生在大约3%的妊娠中,接受诊断可能是家庭的潜在创伤经历。接受诊断的母亲的心理健康以及预测弹性或不良心理健康的因素尚未得到充分研究。情绪调节是一个重要的,可修改,心理健康的诊断因素,可能是诊断后的保护性。评估压力的生物标志物,包括IL-6和恒定载荷(AL),也可以作为风险的早期指标,表明早期干预。这项研究评估了是否重新评估,抑制,在接受胎儿异常诊断后,IL-6和AL与女性的心理健康结果和韧性相关。
方法:孕妇(N=108)到胎儿问题诊所进行初步咨询,完成了情绪调节措施(即,重新评估和抑制),抑郁症,焦虑,创伤后应激症状,和2019-2022年之间的弹性。抽血用于评估IL-6并创建复合同种异体负荷测量,包括:IL-6,血压,心率,葡萄糖,皮质醇,和体重指数。
结果:控制年龄的线性回归,胎龄,和感知的胎儿诊断严重程度,证明IL-6与复原力呈负相关,与抑郁呈正相关。重新评估与韧性呈正相关,与抑郁呈负相关,焦虑,和PTSD,而国家保险状态与焦虑和PTS症状呈正相关。抑制和同种异体载荷不显著。
结论:经历胎儿异常诊断的女性代表了一个未被充分研究的人群,其心理健康需求尚未得到解决。重新评估不仅是一个保护因素,但可以加强以促进产妇的韧性和心理健康。此外,IL-6升高可能是孕妇潜在干预需求的关键早期指标,缓解负面心理状态,增强韧性。
OBJECTIVE: Fetal anomalies occur in approximately 3% of pregnancies and receiving the diagnosis may be a potentially traumatic experience for families. The mental health of mothers receiving diagnoses and what predicts resilience or poor mental health is understudied. Emotion regulation is an important, modifiable, transdiagnostic factor of mental health, and may be protective post-diagnosis. Evaluating biomarkers of stress, including IL-6 and Allostatic Load (AL), can also serve as early indicators of risk, indicative of early intervention. This study assessed whether reappraisal, suppression, IL-6, and AL was associated with mental health outcomes and resilience in women after receiving a fetal anomaly diagnosis.
METHODS: Pregnant women (N=108) presenting to a fetal concerns clinic for initial consultation completed measures of emotion regulation (i.e., reappraisal and suppression), depression, anxiety, posttraumatic stress symptoms, and resilience between 2019-2022. A blood draw was used to assess IL-6 and create composite allostatic load measure including: IL-6, blood pressure, heart rate, glucose, cortisol, and body mass index.
RESULTS: Linear regressions controlling for age, gestational age, and perceived fetal diagnosis severity, demonstrated that IL-6 was negatively associated with resilience and positively associated with depression. Reappraisal was positively associated to resilience and negatively associated with depression, anxiety, and PTSD, whereas state insurance status was positively associated to anxiety and PTS symptoms. Suppression and allostatic load were not significant.
CONCLUSIONS: Women experiencing fetal anomaly diagnosis represent an understudied population with unaddressed mental health needs. Reappraisal serves as not only a protective factor, but one that can be enhanced to promote maternal resilience and mental health. Furthermore, elevated IL-6 may be a critical early indicator of potential intervention needs among women who are pregnant, to mitigate negative psychological states and enhance resilience.