(698) Impact of psychosocial collaboration on parental psychological distress in the setting of Congenital Diaphragmatic Hernia

Friday, February 10, 2023

10:30 AM – 12:00 PM

Objective: To evaluate depressive and traumatic risk in parents receiving a diagnosis of isolated severe (liver-up) vs. moderate (liver-down) congenital diaphragmatic hernia (CDH) and the impact of onsite collaborative psychosocial care.

Study Design: Postpartum Depression Screening Scale (PDSS) and Center for Epidemiological Studies-Depression (CES-D) were used to identify significant depressive risk and The Impact of Events Scale (IES-R) was used to determine traumatic risk in a cohort of pregnant patients and their partners from 2012-2022. Screens were completed following fetal diagnosis of CDH (Time 1) and immediately postpartum (Time 2). Liver-up defined severe and liver-down defined moderate CDH. Demographics and GA at delivery were collected. The number of documented interactions with an embedded psychosocial support team was determined by chart review. Non-isolated CDH cases were excluded.

Results: 462 mothers and 394 partners completed depressive risk screening at both time points. Traumatic risk screening was completed by 460 mothers and 391 partners. Overall, mothers and partners demonstrated increased depressive and traumatic risk at both time points. When analyzed over time, symptoms of depressive and traumatic risk improved in mothers with all CDH diagnoses. Partners showed significant improvement in traumatic symptoms in all CDH diagnoses and specifically in severe CDH. Mothers demonstrated decrease in traumatic symptoms from time 1 to time 2 with moderate but not severe CDH (Tables). The average number of visits with the psychosocial team (in addition to routine care) was 5.3. Those mothers with a higher number of total interactions with psychosocial providers, demonstrated a decreased number of positive screeners at time 2 (p=.001).

Conclusion: Prenatal diagnosis of CDH is associated with increased parental psychological distress, particularly severe CDH. Psychosocial partnerships throughout the prenatal period can help to reduce the negative effects of depression and traumatic stress for this high-risk group of expectant parents.

Primary & Presenting Author(s)

Christina Paidas Teefey, MD
Assistant Professor, Clinical Obstetrics and Gynecology in Surgery
Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States

Coauthor(s)

AB
Alexandria Budney, MPH
Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
LJ
Lilly Jay, PhD
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
RD
Renee Dicicco, MS
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
HH
Holly Hedrick, MD
Center for Fetal Research
Philadelphia, Pennsylvania, United States
Nahla Khalek, MD,MPH,MMedEd
Assistant Professor
Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment at CHOP
Philadelphia, Pennsylvania, United States
Shelly Soni, MD
Assistant Professor
The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Juliana S. Gebb, MD (she/her/hers)
Assistant Professor
Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
JM
Julie S. Moldenhauer, MD
Associate Professor, Director of Obstetrical Services
Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
JC
Joanna Cole, PhD
Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States