Will Expectant Mothers Accept Psychosocial Support After Learning Their Baby Has CHD? This Study Says Yes.

A prenatal diagnosis of congenital heart disease (CHD) can be devastating for expectant mothers and their partners. They often experience traumatic stress, depression, and anxiety which can lead to negative long-term consequences for both family and child. 

To help expectant mothers and their partners better cope with a prenatal diagnosis of CHD, researchers and clinicians at Nemours Children’s Health in Delaware have developed an innovative psychosocial intervention program called HEARTPrep. Delivered virtually through a mobile app and telehealth modalities, the program is currently being piloted at Nemours.

 The three primary aims of the HEARTPrep program are to:

·       Reduce feelings of distress and social isolation among expectant mothers

·       Increase hope and self-efficacy in parenting

·       Facilitate the long-term well-being of family and child

Erica Sood, PhD, Clinical Psychologist at Nemours, was one of the lead researchers and authors of a recently published study that evaluated the feasibility and acceptability of the HEARTPrep program among expectant mothers and their partners. 

Determining feasibility and acceptability is important because prenatal psychosocial intervention programs are rarely used today in this patient population despite the clear need for such services.

Here, we present an overview of the study results.

Favorable feasibility rates

The study evaluated the feasibility of the HEARTPrep program based on rates of enrollment and retention. 

Thirty-nine eligible expectant mothers were recruited for the study after a diagnosis of CHD were recruited for the study. Among these:

·       90% (n=35) enrolled in the intervention program (nearly 50% of partners also participated)

·       77% of enrolled mothers (n=27) completed the intervention

·       71% of enrolled mothers (n=25) completed an evaluation survey for the program

These results demonstrate that the HEARTPrep psychosocial intervention program can be feasibly delivered to mothers and their partners after a prenatal diagnosis of CHD in their baby.

High acceptability ratings

The acceptability of the HEARTPrep program was also assessed as part of the study, through an evaluation survey consisting of 20 Likert-scale questions and five open-ended questions.

Mean acceptability scores for the program ranged from 3.5 to 3.9 on a scale of 0 (not at all acceptable) to 4.0 (very acceptable).

These results indicate high acceptance of psychosocial intervention through HEARTPrep among expectant mothers.

On a scale from 0 (not at all true) to 4.0 (very true), participating mothers reported that the HEARTPrep program made them feel:

·       Less alone (mean score 3.84)

·       Less distressed (mean score 3.74)

·       More hopeful (mean score 3.84)

·       More prepared (mean score 3.89)

Expectant mothers cited the helpfulness of the program in providing them with opportunities to:

·       Develop coping skills

·       Process their emotions

·       Understand they are not alone

·       Connect with peer support

·       Navigate their relationships

·       Learn with their partners

·       Prepare for stressors

·       Access helpful resources

These results demonstrate that psychosocial support through HEARTPrep was a highly acceptable intervention for expectant mothers following a prenatal diagnosis of CHD.

A foundation for further research

Based on this study’s findings, the HEARTPrep program is a feasible and highly acceptable intervention modality that may help ensure families receive psychosocial support after finding out the baby they are expecting has CHD.

This study lays the foundation for further research aimed at evaluating the efficacy of HEARTPrep for improving maternal mental health and postnatal clinical outcomes.

About Dr. Sood

Erica Sood, PhD is a pediatric psychologist in the Nemours Cardiac Center and the Nemours Center for Healthcare Delivery Science at Nemours Children's Health in Wilmington, Delaware. She is an Associate Professor of Pediatrics at the Sidney Kimmel Medical College of Thomas Jefferson University. Dr. Sood's research focuses on neurodevelopmental and psychosocial outcomes in patients with congenital heart disease (CHD) and family-based psychosocial interventions to promote patient and family wellbeing. She directs the Nemours Cardiac Learning and Early Development (LEAD) Program and trains pediatric psychology fellows in the specialty area of cardiac neurodevelopment. Dr. Sood is a previous co-chair (2018-2020) of the Cardiac Neurodevelopmental Outcome Collaborative and serves on the Scientific Advisory Committee for Conquering CHD and on the Medical Advisory Board for Mended Little Hearts. She serves on the editorial boards for the Journal of Pediatric Psychology and Clinical Practice in Pediatric Psychology.