Work

Psychological Impact of Fetal Echocardiography Referral on Pregnant Women With a Normal Routine Morphologic Ultrasound

Year: 2026

Type: article

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.

Source: CJC Pediatric and Congenital Heart Disease

DOI: 10.1016/j.cjcpc.2026.05.005