Psychological Impact of Fetal Echocardiography Referral on Pregnant Women With a Normal Routine Morphologic Ultrasound.
7 affiliations
- 1Faculty of Medicine and Health Sciences, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.
- 2Division of Cardiology, Department of Pediatrics, McGill University Health Centre, Montreal, Québec, Canada.
- 3London Health Sciences Center, Children's Hospital, Western University, London, Ontario, Canada.
- 4Faculty of Medicine, McGill University, Montreal, Québec, Canada.
- 5Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada.
- 6Centre Intégré Universitaire de Santé et de Services Sociaux de l'Ouest-de-l'Île-de-Montréal, Montreal, Québec, Canada.
- 7Centre Hospitalier Universitaire de Québec, Université Laval, Québec City, Québec, Canada.
Abstract
Background
Fetal echocardiography (FE) is widely recommended in pregnancies at increased risk of congenital heart defects. Although FE is a safe diagnostic tool, its psychological impact on expectant pregnant women remains poorly understood.Methods
We conducted a prospective observational study in 8 Canadian centers. Women aged ≥18 years with a normal second-trimester ultrasound between 18 and 26 weeks' gestation referred for an FE were compared with women who were not. Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory. The primary outcome was the difference between state and trait anxiety (net situational anxiety) after morphologic ultrasound but before FE (T0). Secondary outcomes included the proportion of participants with significant anxiety (State-Trait Anxiety Inventory ≥40) and anxiety trajectories after FE among referred participants.Results
Eighty-four women were included, of whom 38 were referred for FE. At T0, women referred for FE showed slightly higher median net situational anxiety compared with controls. In multivariable analyses, FE referral was associated with a modest increase although estimates were imprecise. A higher proportion of referred women reached a state anxiety score ≥40, though this association was weak after adjustment. Among the 14 women who completed post-FE questionnaires, anxiety trajectories were heterogeneous, with both increases and decreases observed after FE.Conclusions
Referral for FE after a normal second-trimester ultrasound is associated with a small and variable increase in maternal anxiety. These findings suggest that FE referral may not be psychologically neutral and highlight the importance of considering maternal psychological responses as referral criteria broaden.
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BibTeX
@article{dufour2026psychological,
title = {{Psychological Impact of Fetal Echocardiography Referral on Pregnant Women With a Normal Routine Morphologic Ultrasound.}},
author = {Camille Dufour and Louis-Olivier Roy and Valérie Taillefer and Maxime Duclos and Evelyne Raiche and Tiscar Cavallé-Garrido and Gitanjali Mansukhani and Richard Brown and Varsha Thakur and Alexandra Ferland-Dorval and Rami Al-Amir-Dach and Melinda Hall and Laurence Vaujois and Frédéric Dallaire and Canadian Congenital and Pediatric Cardiology Research Network},
journal = {CJC pediatric and congenital heart disease},
year = {2026},
month = jun,
doi = {10.1016/j.cjcpc.2026.05.005},
url = {https://europepmc.org/article/MED/42948470},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Psychological Impact of Fetal Echocardiography Referral on Pregnant Women With a Normal Routine Morphologic Ultrasound.
AU - Camille Dufour
AU - Louis-Olivier Roy
AU - Valérie Taillefer
AU - Maxime Duclos
AU - Evelyne Raiche
AU - Tiscar Cavallé-Garrido
AU - Gitanjali Mansukhani
AU - Richard Brown
AU - Varsha Thakur
AU - Alexandra Ferland-Dorval
AU - Rami Al-Amir-Dach
AU - Melinda Hall
AU - Laurence Vaujois
AU - Frédéric Dallaire
AU - Canadian Congenital and Pediatric Cardiology Research Network
PY - 2026
DA - 2026/06/03
JO - CJC pediatric and congenital heart disease
DO - 10.1016/j.cjcpc.2026.05.005
UR - https://europepmc.org/article/MED/42948470
AB - Background Fetal echocardiography (FE) is widely recommended in pregnancies at increased risk of congenital heart defects. Although FE is a safe diagnostic tool, its psychological impact on expectant pregnant women remains poorly understood.Methods We conducted a prospective observational study in 8 Canadian centers. Women aged ≥18 years with a normal second-trimester ultrasound between 18 and 26 weeks' gestation referred for an FE were compared with women who were not. Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory. The primary outcome was the difference between state and trait anxiety (net situational anxiety) after morphologic ultrasound but before FE (T0). Secondary outcomes included the proportion of participants with significant anxiety (State-Trait Anxiety Inventory ≥40) and anxiety trajectories after FE among referred participants.Results Eighty-four women were included, of whom 38 were referred for FE. At T0, women referred for FE showed slightly higher median net situational anxiety compared with controls. In multivariable analyses, FE referral was associated with a modest increase although estimates were imprecise. A higher proportion of referred women reached a state anxiety score ≥40, though this association was weak after adjustment. Among the 14 women who completed post-FE questionnaires, anxiety trajectories were heterogeneous, with both increases and decreases observed after FE.Conclusions Referral for FE after a normal second-trimester ultrasound is associated with a small and variable increase in maternal anxiety. These findings suggest that FE referral may not be psychologically neutral and highlight the importance of considering maternal psychological responses as referral criteria broaden.
SN - 2772-8129
ER -