When uncertainty generates more anxiety than severity: the prenatal experience with cystic adenomatoid malformation of the lung

Aim: To assess reasons for higher levels of anxiety generated by prenatal counselling of a condition with good outcome such as cystic adenomatoid malformation (CCAM) of the lung compared to a life-threatening malformation such as congenital diaphragmatic hernia (CDH). Materials and methods: The Spielberger State-Trait Anxiety Inventory (STAI-S) was used to measure anxiety in two groups of mothers carrying a fetus with the respective malformation. Results: Forty-four mothers completed the questionnaire (CCAM, ns21 and CDH, ns23). Before consultation, the mean STAI-S scores in the CCAM group (44.80"5.92) and in CDH group (44.05"4.96) were not significantly different but was significantly reduced in both groups after consultation (CCAM 44.80 vs. 41.60, Ps0.014 and CDH 44.05 vs. 34.35, Ps0.0001). The groups were not significantly different regarding gestational age at diagnosis. Conclusions: After initial prenatal counselling, uncertainty about prenatal outcome and lack of defined management plans in CCAM seems to be more important than higher mortality rate occurring in CDH.