Maternal Anxiety Surrounding Fetal Cardiac Evaluation: A Prospective Single-Center Cohort Study

Fetal echocardiography has transformed prenatal cardiac diagnosis, yet the emotional burden of referral and evaluation remains poorly characterized. We aimed to quantify maternal anxiety before and after fetal cardiac evaluation (FCE), identify clinical predictors of anxiety, and assess whether anxiety changes following evaluation and consultation regardless of outcome. In this prospective cohort study, 117 pregnant women undergoing initial or follow-up FCE completed pre- and post-consultation assessments using a seven-item symptom inventory adapted from the Stanford Acute Stress Reaction Questionnaire (SASRQ; score range 7-42). Participants were classified as anxious or non-anxious by direct self-report. Scores were compared with paired t-tests; exploratory multivariable models adjusted for clinical, demographic, and referral covariates, including prior pregnancy loss, psychiatric history, and diagnostic outcome. 80% of participants (94/117) reported anxiety about the FCE before evaluation; prior pregnancy loss was associated with anxious state (p = 0.049). Following FCE and consultation, mean symptom scores in the anxious group fell from 15.07 to 9.03, a 6.04-point (40.1%) reduction (p < 0.001), with reductions across symptom domains regardless of diagnostic outcome. Scores in the non-anxious group did not change significantly (8.48 to 7.87; p = 0.27). Most women referred for FCE report anxiety before evaluation. FCE with consultation was associated with a substantial reduction in anxiety symptoms in these women, irrespective of whether a cardiac abnormality was found. Although the uncontrolled pre-post design cannot establish causation, these findings suggest that diagnostic clarity and expert consultation may themselves be anxiety-reducing and support evaluation of integrated psychosocial care models in fetal cardiology.