Impact of Monochorionicity and Twin to Twin Transfusion Syndrome on Prenatal Attachment, Post Traumatic Stress Disorder, Anxiety and Depressive Symptoms

• Published in: PloS one 2016-01, Vol.11 (1), p.e0145649-e0145649
• Main Authors: Beauquier-Maccotta, Berengere, Chalouhi, Gihad E, Picquet, Anne-Laure, Carrier, Aude, Bussières, Laurence, Golse, Bernard, Ville, Yves
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Anxiety - physiopathology; Anxiety - prevention & control; Anxiety - psychology; Attachment; Child & adolescent psychiatry; Chorion - blood supply; Chorion - physiopathology; Complications; Depression - physiopathology; Depression - prevention & control; Depression - psychology; Directive Counseling; Female; Fetofetal Transfusion - physiopathology; Fetuses; Hospitals; Humans; Medical prognosis; Mental depression; Mental disorders; Mothers; Object Attachment; Obstetrics; Patients; Polyamide-imides; Post traumatic stress disorder; Postpartum depression; Posttraumatic stress disorder; Pregnancy; Pregnancy complications; Pregnancy, High-Risk - psychology; Pregnancy, Twin - psychology; Premature birth; Prenatal experience; Stress Disorders, Post-Traumatic - physiopathology; Stress Disorders, Post-Traumatic - prevention & control; Stress Disorders, Post-Traumatic - psychology; Transfusion; Twins; Twins, Monozygotic; Ultrasonic imaging; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0145649

Monochronioric (MC) twin pregnancies are considered as high-risk pregnancies with potential complications requiring in-utero interventions. We aimed to assess prenatal attachment, anxiety, post-traumatic stress disorder (PTSD) and depressive symptoms in MC pregnancies complicated with Twin-To-Twin-transfusion syndrome (TTTS) in comparison to uncomplicated monochorionic (UMC) and dichorionic pregnancies (DC). Auto-questionnaires were filled out at diagnosis of TTTS and at successive milestones. Prenatal attachment, PTSD, anxiety and perinatal depression were evaluated respectively by the Prenatal Attachment Inventory (PAI) completed for each twin, the Post-traumatic Checklist Scale (PCLS), the State-Trait Anxiety Inventory (STAI) and the Edinburgh Perinatal Depression Scale (EPDS). There was no significant difference in the PAI scores between the two twins. In the DC and UMC groups, PAI scores increased throughout pregnancy, whilst it didn't for TTTS group. TTTS and DC had a similar prenatal attachment while MC mothers expressed a significantly higher attachment to their fetuses and expressed it earlier. At the announcement of TTTS, 72% of the patients present a score over the threshold at the EPDS Scale, with a higher score for TTTS than for DC (p = 0.005), and UMC (p = 0.007) at the same GA. 30% of mothers in TTTS group have PTSD during pregnancy. 50% of TTTS- patients present an anxiety score over the threshold (STAI-Scale), with a score significantly higher in TTTS than in UMC (p