Parental Psychological Response to Prenatal Congenital Heart Defect Diagnosis

This systematic review aims to summarize the most recent data from the literature on the psychological aspects of parents of children prenatally diagnosed with congenital heart defects (CHDs).

A comprehensive literature search was conducted to identify relevant studies on the psychological issues faced by parents of children prenatally diagnosed with CHD. Searches were performed in multiple scientific databases, including PubMed, Science direct, Embase, Scopus, Medline, Clarivate, to ensure the broad coverage of the literature. The search was limited to studies published up until February 2025. The search strategy included the following terms and combinations: "congenital heart defect" OR "CHD" AND "prenatal diagnosis" AND "psychological impact" OR "parental distress" OR "coping".

Eighteen studies involving the 673 parents of fetuses diagnosed with congenital heart defects were included. Studies spanned four continents and employed both qualitative (n = 14) and quantitative (n = 4) designs. Key psychological outcomes reported were anxiety, depression, stress, post-traumatic stress, coping strategies, maternal-fetal attachment, and life satisfaction. Anxiety and depression were the most frequent issues, with maternal anxiety reaching 65% and depression up to 45.7%. Stress related to diagnostic uncertainty was common. While some parents used adaptive coping (social support, emotional regulation), others experienced maladaptive patterns such as avoidance. One study reported increased maternal-fetal attachment following prenatal CHD diagnosis. Predictors of psychological distress included time of diagnosis, parental gender, education level, social support, and severity of the defect. Recommended interventions included early psychological screening, empathetic communication, structured counseling, and long-term emotional support. Despite heterogeneity in design and moderate overall bias, findings highlight a consistent psychological burden among parents, underscoring the need for integrated psychosocial care following a prenatal CHD diagnosis.

Parents whose children have been prenatally diagnosed with a congenital heart defect are at an increased risk for psychological distress. To improve the quality of care, a multidisciplinary team is needed to provide parents with the necessary information on diagnosis, interventions, and potential outcomes.