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Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele.

Publication ,  Journal Article
Antiel, RM; Adzick, NS; Thom, EA; Burrows, PK; Farmer, DL; Brock, JW; Howell, LJ; Farrell, JA; Houtrow, AJ ...
Published in: Am J Obstet Gynecol
October 2016

BACKGROUND: The Management of Myelomeningocele Study was a multicenter, randomized controlled trial that compared prenatal repair with standard postnatal repair for fetal myelomeningocele. OBJECTIVE: We sought to describe the long-term impact on the families of the women who participated and to evaluate how the timing of repair influenced the impact on families and parental stress. STUDY DESIGN: Randomized women completed the 24-item Impact on Family Scale and the 36-item Parenting Stress Index Short Form at 12 and 30 months after delivery. A revised 15-item Impact on Family Scale describing overall impact was also computed. Higher scores reflected more negative impacts or greater stress. In addition, we examined Family Support Scale and Family Resource Scale scores along with various neonatal outcomes. Repeated measures analysis was conducted for each scale and subscale. RESULTS: Of 183 women randomized, 171 women completed the Impact on Family Scale and 172 completed the Parenting Stress Index at both 12 and 30 months. The prenatal surgery group had significantly lower revised 15-item Impact on Family Scale scores as well as familial-social impact subscale scores compared to the postnatal surgery group (P = .02 and .004, respectively). There was no difference in total parental stress between the 2 groups (P = .89) or in any of the Parenting Stress Index Short Form subscales. In addition, walking independently at 30 months and family resources at 12 months were associated with both family impact and parental stress. CONCLUSION: The overall negative family impact of caring for a child with spina bifida, up to 30 months of age, was significantly lower in the prenatal surgery group compared to the postnatal surgery group. Ambulation status and family resources were predictive of impact on family and parental stress.

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Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

October 2016

Volume

215

Issue

4

Start / End Page

522.e1 / 522.e6

Location

United States

Related Subject Headings

  • Stress, Psychological
  • Risk Factors
  • Postnatal Care
  • Parents
  • Obstetrics & Reproductive Medicine
  • Meningomyelocele
  • Infant
  • Humans
  • Gestational Age
  • Fetus
 

Citation

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Antiel, R. M., Adzick, N. S., Thom, E. A., Burrows, P. K., Farmer, D. L., Brock, J. W., … Management of Myelomeningocele Study Investigators, . (2016). Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele. Am J Obstet Gynecol, 215(4), 522.e1-522.e6. https://doi.org/10.1016/j.ajog.2016.05.045
Antiel, Ryan M., N Scott Adzick, Elizabeth A. Thom, Pamela K. Burrows, Diana L. Farmer, John W. Brock, Lori J. Howell, Jody A. Farrell, Amy J. Houtrow, and Amy J. Management of Myelomeningocele Study Investigators. “Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele.Am J Obstet Gynecol 215, no. 4 (October 2016): 522.e1-522.e6. https://doi.org/10.1016/j.ajog.2016.05.045.
Antiel RM, Adzick NS, Thom EA, Burrows PK, Farmer DL, Brock JW, et al. Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele. Am J Obstet Gynecol. 2016 Oct;215(4):522.e1-522.e6.
Antiel, Ryan M., et al. “Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele.Am J Obstet Gynecol, vol. 215, no. 4, Oct. 2016, pp. 522.e1-522.e6. Pubmed, doi:10.1016/j.ajog.2016.05.045.
Antiel RM, Adzick NS, Thom EA, Burrows PK, Farmer DL, Brock JW, Howell LJ, Farrell JA, Houtrow AJ, Management of Myelomeningocele Study Investigators. Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele. Am J Obstet Gynecol. 2016 Oct;215(4):522.e1-522.e6.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

October 2016

Volume

215

Issue

4

Start / End Page

522.e1 / 522.e6

Location

United States

Related Subject Headings

  • Stress, Psychological
  • Risk Factors
  • Postnatal Care
  • Parents
  • Obstetrics & Reproductive Medicine
  • Meningomyelocele
  • Infant
  • Humans
  • Gestational Age
  • Fetus