Introduction: When an ultrasound detects a soft marker, pregnant women are currently offered cytogenetic testing to rule out a fetal chromosomal abnormality. In the majority of cases, the result is reassuring and the neonatal outcome satisfactory. Although it can offer reassurance, carrying out this prenatal diagnostic work may affect maternal representations and the mother’s emotional state, as well as impairing mother – infant attachment. Objectives: Our goal was to evaluate whether using a novel genetic technique, chromosomal microarray analysis (CMA), in addition to conventional karyotyping for fetal soft markers, would affect the mother’s emotional state and maternal representations, and whether this impact would be similar to the impact of soft markers without CMA. Method: We compared a group of women with fetal soft markers plus CMA, with a favorable neonatal outcome (n = 10), to controls without any ultrasound abnormality (n = 10), and to a historical series of women with fetal soft markers without CMA, also with a favorable neonatal outcome (n = 18). The outcome criteria measured one-week postpartum were: the mean Covi score and STAI anxiety scores, the Raskin depression score, and the distribution of maternal representation characteristics based on the Interview of Maternal Representations During Pregnancy (IRMAG). Results: In the group with CMA, the mean Raskin depression score (3.8) was significantly higher than in the controls (2) (p < 0.05). Integrated/balanced representations were significantly less frequent in the CMA group (n = 4) than in controls (n = 9), while restricted/disengaged (CMA group n = 4) and non-integrated (CMA group n = 2) representations were more frequent than in controls (1 and 0 respectively) p < 0.0001. Maternal representations showed less richness, coherence, social referencing, and fantasies than in controls (p < 0.05). In the group with CMA, maternal representations were less affected than in the historical series of women without CMA. Conclusion: Following prenatal diagnosis of soft markers, maternal representations were altered despite a reassuring fetal karyotype and CMA, and a normal neonatal outcome. However, this alteration was no greater than in historical cases of soft markers without CMA.
|Translated title of the contribution||Does fetal chromosomal microarray genetic screening for minor ultrasound anomalies affect maternal representations and the mother’s emotional state: An exploratory study|
|Number of pages||13|
|State||Published - 15 Jul 2020|
- Emotional impact
- Fetal soft marker
- Maternal representations
- Prenatal diagnosis