Salud Mental

Post-traumatic stress disorder after subsequent birth to a gestational loss: An observational study

##plugins.themes.bootstrap3.article.main##

Eloísa Fernández Ordóñez
Cristóbal Rengel Díaz
Isabel María Morales Gil
María Teresa Labajos Manzanares

Abstract

Introduction. The loss of a pregnancy puts women at risk of suffering post-traumatic stress disorder. This circumstance can influence a subsequent pregnancy, and the link with the future baby.

Objective. The main objective of this work was to identify the prevalence of post-traumatic stress disorder (PTSD) among post-partum women who give birth after having suffered a previous gestational loss and to identify possible relationships between PTSD and the variables studied.

Method. An observational, descriptive, and cross-sectional study. A total of 115 puerperal women who had suffered a previous gestational loss completed questionnaires containing sociodemographic variables, obstetric history, and responses to the Davidson Trauma Scale.

Results. A score of 40 was established as a cut-off point in the Davidson Trauma Scale for the identification of PTSD. 21.7% of the participants scored 40 or above. Significant differences were found related to age (p = .030), number of pregnancies (p = .033), and number of gestational losses (p = .001). The probability of PTSD increases significantly in relation to the number of losses. Respondents are 2.55 times (β = .94 p = .027) more likely to suffer PTSD the higher the number of gestational losses suffered.

Discussion and conclusion. There are significant differences in the presence of PTSD among puerperal women in terms of age, number of pregnancies, and number of gestational losses. Post-partum women are more likely to suffer PTSD after a gestational loss the higher the number of gestational losses suffered.
Keywords:
Mental health, perinatal loss, grief, pregnancy, post-traumatic stress disorders

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.) Washington, DC: American Psychiatric Association.

Armstrong, D. S., Hutti, M. H., & Myers, J. (2009). The Influence of Prior Perinatal Loss on Parents’ Psychological Distress After the Birth of a Subsequent Healthy Infant. Journal of Obstetric, Gynecologic & Neonatal Nursing, 38(6), 654-666. doi: 10.1111/j.1552-6909.2009.01069.x

Bobes, J., Calcedo-Barba, A., García, M., François, M., Rico-Villademoros, F., González, M. P., & Bousoño, M. (2000). Evaluación de las propiedades psicométricas de la versión española de cinco cuestionarios para la evaluación del Trastorno de Estrés Postraumático. Actas Españolas de Psiquiatría, 28(4), 207-218.

Boltanski, L. (2016). La condición fetal: una sociología del engendramiento y del aborto. Madrid: Akal.

Christiansen, D. M. (2017). Posttraumatic stress disorder in parents following infantdeath: A systematic review. Clinical Psychology Review, 51, 60-74. doi:10.1016/j.cpr.2016.10.007

Cook, N., Ayers, S., & Horsch, A. (2018). Maternal posttraumatic stress disorder during the perinatal period and child outcomes: A systematic review. Journal of Affective Disorders, 225, 18-31. doi: 10.1016/j.jad.2017.07.045

Cordle, C. J., & Prettyman, R. J. (1994). A 2-year follow-up of women who have experienced early miscarriage. Journal of Reproductive and Infant Psychology, 12(1), 37-43. doi: 10.1080/02646839408408866

Cuisinier, M. C. J., Kuijpers, J. C., Hoogduin, C. A. L., de Graauw, C. P. H. M., & Janssen, H. J. E. M. (1993). Miscarriage and stillbirth : time since the loss, grief intensity andsatisfaction with care. European Journal of Obstetric & Gynecology and Reproductive Biology, 52(3), 163-168. doi: 10.1016/0028-2243(93)90066-L

Daugirdaitė, V., van den Akker, O., & Purewal, S. (2015). Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review. Journal of Pregnancy, 1-14. doi: 10.1155/2015/646345

Davidson, J. R., Book, S. W., Colket, J. T., Tupler, L. A., Roth, S., David, D., ... Feldman, M. E. (1997). Assessment of a new self-rating scale for post-traumatic stress disorder. Psychological medicine, 27(1), 153-160. doi: 10.1017/S0033291796004229

DeBackere, K. J., Hill, P. D., & Kavanaugh, K. L. (2008). The Parental Experience of Pregnancy After Perinatal Loss. Journal of Obstetric, Gynecologic & Neonatal Nursing, 37(5), 525-537. doi: 10.1111/j.1552-6909.2008.00275.x

Engelhard, I. M., van den Hout, M. A., & Arntz, A. (2001). Posttraumatic stress disorder after pregnancy loss. General Hospital Psychiatry, 23(2), 62-66. doi: 10.1016/S0163-8343(01)00124-4

Figueroa, R. A., Cortés, P. F., Accatino, L., & Sorensen, R. (2016). Trauma psicológico en la atención primaria: orientaciones de manejo. Revista médica de Chile, 144(5), 643-655. doi: 10.4067/s0034-98872016000500013

Giannandrea, S. A. M., Cerulli, C., Anson, E., & Chaudron, L. H. (2013). Increased Risk for Postpartum Psychiatric Disorders Among Women with Past Pregnancy Loss. Journal of Women’s Health, 22(9), 760-768. doi: 10.1089/jwh.2012.4011

Haagen, J. F. G., Moerbeek, M., Olde, E., van der Hart, O., & Kleber, R. J. (2015). PTSD after childbirth : A predictive ethological model for symptom development. Journal of Affective Disorders, 185, 135-143. doi:10.1016/j.jad.2015.06.049

Hughes, P. M., Turton, P., & Evans, C. D. H. (1999). Stillbirth as risk factor for depression and anxiety in the subsequent pregnancy: Cohort study. British Medical Journal, 318(7200), 1721-1724. doi: 10.1136/bmj.318.7200.1721

Hutti, M. H., Armstrong, D. S., Myers, J. A., & Hall, L. A. (2015). Grief Intensity, Psychological Well‐Being, and the Intimate Partner Relationship in the Subsequent Pregnancy after a Perinatal Loss. Journal of Obstetric, Gynecologic & Neonatal Nursing, 44(1), 42-50. doi: 10.1111/1552-6909.12539

Krosch, D. J., & Shakespeare-Finch, J. (2017). Grief, traumatic stress, and posttraumatic growth in women who have experienced pregnancy loss. Psychological Trauma: Theory, Research, Practice, and Policy, 9(4), 425-433. doi: 10.1037/tra0000183

Rojas Campos, M. (2016). Trastorno de Estrés Postraumático. Revista Médica de Costa Rica y Centroamérica, 73(619), 233-240. Retrieved from https://www.medigraphic.com/pdfs/revmedcoscen/rmc-2016/rmc162h.pdf

Turton, P., Hughes, P., Evans, C. D. H., & Fainman, D. (2001). Incidence, correlates and predictors of post-traumatic stress disorder in the pregnancy after stillbirth. British Journal of Psychiatry, 178(6), 556-560. doi: 10.1192/bjp.178.6.556

Vignato, J., Georges, J. M., Bush, R. A., & Connelly, C. D. (2017). Post-traumatic stress disorder in the perinatal period: A concept analysis. Journal of Clinical Nursing, 26(23-24), 3859-3868. doi: 10.1111/jocn.13800

Yehuda, R., & McFarlane, A. C. (1995). Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis. American Journal of Psychiatry, 152(12), 1705-1713. doi:10.1176/ajp.152.12.1705

Yildiz, P. D., Ayers, S., & Phillips, L. (2017). The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis. Journal of Affective Disorders, 208, 634-645. doi: 10.1016/j.jad.2016.10.009