February 13, 2020
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Pregnancy loss linked to posttraumatic stress

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Women experience increased levels of posttraumatic stress, anxiety and depression after experiencing a miscarriage or ectopic pregnancy, according to a study recently published in the American Journal of Obstetrics and Gynecology.

“Pregnancy loss affects up to one in two women, and for many women it will be the most traumatic event in their life,” Tom Bourne, MBBS, PhD, a professor of practice in gynecology in the department of metabolism, digestion and reproduction at Imperial College London, said in a press release. “This research suggests the loss of a longed-for child can leave a lasting legacy, and result in a woman still suffering posttraumatic stress nearly a year after her pregnancy loss.”

Bourne and colleagues conducted a prospective cohort study to evaluate the prevalence of posttraumatic stress, anxiety and depression in women in the 9 months following an early pregnancy loss.

The study included women who presented at three hospitals in London and experienced ectopic pregnancy, miscarriage, or a resolving or persistent pregnancy of an unknown location during follow-up. Those who agreed to participate were sent email surveys that included psychological assessments at 1 month, 3 months and 9 months. Researchers also included a control group of women with viable pregnancies.

 
Women experience increased levels of posttraumatic stress, anxiety and depression after experiencing a miscarriage or ectopic pregnancy, according to a study recently published in the American Journal of Obstetrics and Gynecology.
Source: Adobe Stock

Among those with early pregnancy loss who agreed to participate, 492 completed assessment at 1 month, 426 completed it at 3 months, and 338 completed it at 9 months. A total of 87 women with healthy pregnancies participated.

Researchers found after pregnancy loss, 29% of women had posttraumatic stress at 1 month and 18% had it after 9 months (OR per month = 0.8; 95% CI, 0.72-0.89).

Moderate to severe anxiety was reported by 24% of women at 1 month and 6% of women 9 months after a pregnancy loss, according to researchers.

Bourne and colleagues found that among those with early pregnancy loss, moderate to severe depression was reported by 11% of women at 1 month and 6% at 9 months.

Among women with miscarriage, researchers discovered that after 9 months, 16% had posttraumatic stress, 17% had anxiety and 5% had depression.

Nine months after an ectopic pregnancy, 21% of women had posttraumatic stress, 23% had anxiety and 11% had depression, according to researchers.

In comparison, Bourne and colleagues found that among women with viable pregnancies, 13% reported moderate to severe anxiety (OR loss at 1 month vs. controls = 2.14; 95% CI, 1.14-4.36) and 2% reported moderate to severe depression (OR loss at 1 month vs. control subjects = 3.88; 95% CI, 1.27-19.2).

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“The treatment women receive following early pregnancy loss must change to reflect its psychological impact, and recent efforts to encourage people to talk more openly about this very common issue are a step in the right direction,” Bourne said in the release. “Whilst general support and counselling will help many women, those with significant posttraumatic stress symptoms require specific treatment if they are going to recover fully.”

Bourne added that physicians “need to consider screening women following an early pregnancy loss so we can identify those who most need help.” – by Erin Michael

Disclosures: The authors report no relevant financial disclosures.