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

Published online by Cambridge University Press:  30 September 2021

Kristina M. Espinosa Open the ORCID record for Kristina M. Espinosa [Opens in a new window] ,
Melissa Julian ,
Yao Wu ,
Catherine Lopez ,
Mary T. Donofrio ,
Anita Krishnan Open the ORCID record for Anita Krishnan [Opens in a new window] ,
Suma Goudar ,
Stephanie Bowers ,
Scott Douglas-Barnett  and
Catherine Limperopoulos Open the ORCID record for Catherine Limperopoulos [Opens in a new window]
...Show all authors
Kristina M. Espinosa
Affiliation:
Developing Brain Institute, Children’s National Hospital, Washington, DC, USA
Melissa Julian
Affiliation:
Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA
Yao Wu
Affiliation:
Developing Brain Institute, Children’s National Hospital, Washington, DC, USA
Catherine Lopez
Affiliation:
Developing Brain Institute, Children’s National Hospital, Washington, DC, USA
Mary T. Donofrio
Affiliation:
Division of Cardiology, Children’s National Hospital, Washington, DC, USA
Anita Krishnan
Affiliation:
Division of Cardiology, Children’s National Hospital, Washington, DC, USA
Suma Goudar
Affiliation:
Division of Cardiology, Children’s National Hospital, Washington, DC, USA
Stephanie Bowers
Affiliation:
Division of Cardiology, Children’s National Hospital, Washington, DC, USA
Scott Douglas-Barnett
Affiliation:
Developing Brain Institute, Children’s National Hospital, Washington, DC, USA
Catherine Limperopoulos*
Affiliation:
Developing Brain Institute, Children’s National Hospital, Washington, DC, USA
Huynh-Nhu Le
Affiliation:
Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA
*
Author for Correspondence: Catherine Limperopoulos, PhD, Developing Brain Institute, Children’s National Hospital, 111 Michigan Ave NW, Washington, DC20010, USA. Tel: 202 476 5293; Fax: 202-476-6833. E-mail: climpero@childrensnational.org
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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.

Keywords

Congenital heart diseasematernal mental healthmaternal interventionprenatal diagnosispsychological stress
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 8 , August 2022 , pp. 1268 - 1275
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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