Le déni de grossesse : un défi clinique et psychologique

Key points • Denial of pregnancy, described since the 17th century, named in 1976 but conceptualized only in the 21st century, is characterized by a lack of awareness of the pregnancy by the mother, despite physical signs that are often attenuated or absent. • The prevalence is estimated to be between 1/300 and 1/475 births, with total forms (discovered at delivery) being rarer (1/2,455). • Numerous mechanisms have been described to explain denial of pregnancy, with as many theoretical frameworks as there are situations encountered. It is important not to generalize hypotheses. • The consequences for the mother and child are variable, but increased vigilance is necessary to prevent risks of perinatal morbidity and mortality. The long-term outcomes for these children remain unknown. • Although there is no specific psychiatric profile or personality type among affected women, vulnerability factors seem to include a personal history of pregnancy denial, social precarity, and an insecure attachment style. • Management should be multidisciplinary, combining psychological, obstetric, and social support.