Post-Traumatic Stress in Mothers of Children Having Complex Cardiac Surgery Early in Life.

Abstract

To determine: (i) frequency of probable post-traumatic stress disorder (PTSD) in mothers of infants after complex cardiac surgery (CCS), (ii) predictors of probable PTSD, and (iii) impact on child neurodevelopment. The Impact of Event Scale-Revised (IES-R) was administered to 60 mothers of infants ≥ 6 months after CCS at ≤ 6 weeks of age. The IES-R measures response to a specific traumatic event: Scores < 24, no concern; 24-32, clinical concern; and ≥ 33, probable diagnosis of PTSD. Post-survey childhood outcomes obtained at 21-months used Bayley Scales of Infant and Toddler Development-Third Edition. Multiple logistic and linear regressions were used to predict high IES-R scores from peri-operative and demographic variables and determine association between maternal IES-R scores and outcomes, reported as Odds Ratio (OR) and Effect Size (ES) with 95% Confidence Intervals (95% CI). IES-R scores ≥ 33 occurred in 14/60 (23%) of mothers. Significant risk factors for IES-R ≥ 33 were days of ventilation after first surgery, OR 1.149 (95% CI 1.037, 1.273), p = 0.008, and birth weight z-scores, OR 0.352 (0.140, 0.881), p = 0.026. Bayley cognitive, language, and motor scores were significantly lower for children whose mothers had IES-R ≥ 33. The IES-R was independently associated with cognitive, ES -0 .23 (95%CI -0 0.39, -0 0.08), p = 0.036 and language, ES -0 0.17 (95%CI -0 0.33, -0 0.06), p = 0.043 scores. Probable PTSD occurred in 23% of mothers ≥ 6 month after discharge of their infant following CCS. Toddlers of mothers with probable PTSD had lower cognitive and language scores suggesting a relation between PTSD and development requiring further study.