Mothers of children with severe heart disease are more likely to suffer from anxiety and depression than mothers of healthy children, even once any medical interventions are over.
Every year some 500 children with congenital heart defects are born in Norway. Most of them survive, but how does the children's illness affect the mental health of their mothers?
"Having a baby with a heart defect can be a shock. In the most severe cases, surgery must be performed immediately after birth as well as several times more during the child's first year of life," explains Řivind Solberg, a doctoral fellow in psychology at the Norwegian Institute of Public Health in Oslo.
Mr Solberg's doctoral research is funded under the Research Council's Programme on Mental Health. His study is part of a larger-scale project at the Norwegian Institute of Public Health, that itself is part of a research initiative entitled "Mothers of children with congenital heart disease (CHD): psychosocial problems from pregnancy through child age 3 years" (HEARTMOMS), a collaborative project being carried out by researchers in the field of psychology and paediatrics at both the national and the international level.
Some 50,000 mothers involved in the study
As Mr Solberg explains, roughly 10 per cent of all new mothers experience a depressive reaction after childbirth that can vary from mild to severe. "We want to find out whether mothers of children with congenital heart defects experience a greater negative impact on their mental health than mothers of healthy children, and whether the degree of severity of the children's heart condition makes a difference," explains Mr Solberg.
The project links data from Rikshospitalet University Hospital's registry of congenital heart defects (BERTE) with psychological and social data from the Norwegian Mother and Child Cohort Study (MoBa). Some 50 000 mothers are included in Mr Solberg's study, some 250 of whom have children with heart defects.
Worse off than before
The first findings indicate that mothers of children with mild or moderate heart defects adjust well and do not differ significantly from the mothers in the control group.
Mothers of children with severe heart defects, on the other hand, are more likely to suffer from anxiety and depression 6 to 18 months after giving birth, both as compared to the control group and to their own mental health state during pregnancy.
"The mothers are monitored regularly from early on in the pregnancy until their children are three years old. This gives us insight into how they were coping before their children were born and allows us to monitor the course of their psychological reaction over time," explains Margarete Vollrath, who heads the project at the Norwegian Institute of Public Health. The figures obtained at the three-year stage have not yet been analysed.
"What is interesting is that the mothers still suffer from anxiety and depression once their children have reached the age of 18 months and most of the medical interventions are over," states Ms Vollrath.
This can partly be explained by the fact that children with congenital heart disease often have a greater need for care and follow-up from their mothers. The mothers spend long periods of time at the hospital, particularly in the child's first year of life when most of the medical interventions are carried out. Concerns about the child's health and future can lead to chronic mental strain, in a situation that does not allow for sufficient rest and restitution.
Relationships with partners and contentment with life not greatly affected
One piece of positive news, however, is that the child's heart disease does not appear to have a negative impact on the mothers' relationships with their partners or their general contentment with life, at least not during the first six months of the child's life. This was one of the findings of an ongoing study carried out under the HEARTMOMS project.
Children need follow-up
"Mental health and development in children with congenital heart disease" (HEARTKIDS) is a project that runs parallel to the HEARTMOMS project. Researchers involved in the project have been conducting research on the sick children themselves. They have found that newborn babies with severe heart defects are more likely to be irritable and more difficult to pacify than other children. Children with heart defects also often have developmental problems.
"The results show that saving these children on the operating table is only half the battle -- these children also need close follow-up afterwards. The same applies to several of the children's mothers and the families in general," says Řivind Solberg.
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