Maternal distress and congenital malformations: do mothers of malformed fetuses have more problems?

As compared with 580 randomly chosen pregnant women without malformed offspring. 161 women with malformed offspring at the index pregnancy had a more frequent history of previous multiple offspring deaths and somewhat increased maternal age but were not different on social class, marital or cohabitation status or parity. As compared with demographically similar reproducing women (n = 54) interviewed, malformation cases (n = 98) reported having had significantly more strong stress before identification of the malformation, as well as a clear tendency toward less appropriate timing of the pregnancy. Women with malformed offspring represent a psychosocially vulnerable group and should receive special clinical and personal support.

Anomalies and the mental health professional.

Parental attitudes and reactions to the identification of fetal anomalies generally represent well-documented, normally occurring phenomena. The appropriate clinical management of such emotional reactions is an important responsibility of the medical units delivering care and services to the parents. Medical policy decisions about whether and when to screen for offspring anomalies is a considerably more complex and controversial topic. Attitudes, feelings, and reactions both of parents and professionals to the identification of fetal abnormality and fetal normality have come to play an increasingly important role in such policy decisions. Adequate evaluation of the topic requires scientifically based knowledge of the psychological and psychosocial effects of screening of normal-risk and high-risk cases, as well as the short-term and long-term consequences of true positive, true negative, false negative, and false positive identifications of offspring abnormality. Only partial answers to these questions are available to date, and further empirical work is needed.