Abstract

Objectives

The aim of the study was to investigate decision making for or against multifetal pregnancy reduction (MFPR) and psychological outcome in women with a triplet pregnancy.

Methods

We investigated medical and sociodemographic variables and characteristics of the decision process for or against MFPR in forty women with triplet pregnancies who had either undergone MFPR (MFPR-group: N = 10) or had delivered triplets (triplet-group: N = 30). Moreover, emotional experiences of the reduction procedure were assessed. Psychological outcome was measured using the Beck Depression inventory (BDI) and the 36-Item Short Form Health Survey (SF-36).

Results

Women of the MFPR-group had a higher gestational age at delivery (p = 0.001), shorter NICU stay (p = 0.001), higher educational level (p = 0.010), more frequently utilized psychological counseling during the decision process (p = 0.016), rated their gynecologist as more helpful for the decision (p = 0.045), required more time for their decision (p = 0.016), and were more likely to be in paid employment at follow-up (p = 0.041) than women of the triplet-group. MFPR was experienced as stressful (90%) or terrifying (10%). At 3.2 (±2.2) years after delivery, the vast majority of women in both groups were free from clinically relevant depression.

Conclusions

MFPR, though associated with emotional distress related to the procedure, results in a satisfactory psychological outcome in the majority of women. The decision for or against MFPR may be related to sociodemographic (such as educational) variables, which further supports the concept of framing in medical decision making. Having triplets most probably is associated with multiple (e.g. social or economic) consequences that may remain poorly investigated.

中文翻译：

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三个或更少？对 40 名三胞胎妊娠妇女的选择性减量和心理结果的支持或反对决策

摘要

目标

该研究的目的是调查支持或反对多胎妊娠减少 (MFPR) 的决策以及三胞胎妊娠女性的心理结果。

方法

我们调查了 40 名接受 MFPR（MFPR 组：N  = 10）或已分娩三胞胎（三胞胎组：N  = 30）的三胞胎妊娠妇女的医学和社会人口学变量以及支持或反对 MFPR 的决策过程的特征。此外，还评估了还原过程的情绪体验。使用贝克抑郁量表 (BDI) 和 36 项简表健康调查 (SF-36) 测量心理结果。

结果

MFPR 组女性分娩时的胎龄较高 ( p  = 0.001)、NICU 住院时间较短 ( p  = 0.001)、教育水平较高 ( p  = 0.010)、在决策过程中更频繁地使用心理咨询 ( p  = 0.016) )，认为她们的妇科医生对决定更有帮助 ( p  = 0.045)，需要更多时间做出决定 ( p  = 0.016)，并且在随访时更有可能从事有偿工作 ( p  = 0.041)三元组。MFPR 被认为有压力 (90%) 或可怕 (10%)。在分娩后 3.2 (±2.2) 年时，两组中的绝大多数女性都没有临床相关的抑郁症。

结论

MFPR 虽然与手术相关的情绪困扰有关，但在大多数女性中会产生令人满意的心理结果。支持或反对 MFPR 的决定可能与社会人口学（如教育）变量有关，这进一步支持了医疗决策中的框架概念。三胞胎很可能与多种（例如社会或经济）后果相关，这些后果可能仍未得到充分研究。