Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study.

Autor:	Farren J; Tommy's National Centre for Miscarriage Research, Queen Charlottes and Chelsea Hospital, Imperial College, London, UK., Jalmbrant M; South London and Maudsley NHS Foundation Trust, London, UK., Ameye L; Department of Development and Regeneration, KU Leuven, Leuven, Belgium., Joash K; Tommy's National Centre for Miscarriage Research, Queen Charlottes and Chelsea Hospital, Imperial College, London, UK., Mitchell-Jones N; Chelsea and Westminster NHS Trust, London, UK., Tapp S; Tommy's National Centre for Miscarriage Research, Queen Charlottes and Chelsea Hospital, Imperial College, London, UK., Timmerman D; Department of Development and Regeneration, KU Leuven, Leuven, Belgium.; Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium., Bourne T; Tommy's National Centre for Miscarriage Research, Queen Charlottes and Chelsea Hospital, Imperial College, London, UK.; Department of Development and Regeneration, KU Leuven, Leuven, Belgium.; Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2016 Nov 02; Vol. 6 (11), pp. e011864. Date of Electronic Publication: 2016 Nov 02.
DOI:	10.1136/bmjopen-2016-011864
Abstrakt:	Objectives: This is a pilot study to investigate the type and severity of emotional distress in women after early pregnancy loss (EPL), compared with a control group with ongoing pregnancies. The secondary aim was to assess whether miscarriage or ectopic pregnancy impacted differently on the type and severity of psychological morbidity. Design: This was a prospective survey study. Consecutive women were recruited between January 2012 and July 2013. We emailed women a link to a survey 1, 3 and 9 months after a diagnosis of EPL, and 1 month after the diagnosis of a viable ongoing pregnancy. Setting: The Early Pregnancy Assessment Unit (EPAU) of a central London teaching hospital. Participants: We recruited 186 women. 128 had a diagnosis of EPL, and 58 of ongoing pregnancies. 11 withdrew consent, and 11 provided an illegible or invalid email address. Main Outcome Measures: Post-traumatic stress disorder (PTSD) was measured using the Post-traumatic Diagnostic Scale (PDS), and anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). Results: Response rates were 69/114 at 1 month and 44/68 at 3 months in the EPL group, and 20/50 in controls. Psychological morbidity was higher in the EPL group with 28% meeting the criteria for probable PTSD, 32% for anxiety and 16% for depression at 1 month and 38%, 20% and 5%, respectively, at 3 months. In the control group, no women met criteria for PTSD and 10% met criteria for anxiety and depression. There was little difference in type or severity of distress following ectopic pregnancy or miscarriage. Conclusions: We have shown a large number of women having experienced a miscarriage or ectopic pregnancy fulfil the diagnostic criteria for probable PTSD. Many suffer from moderate-to-severe anxiety, and a lesser number depression. Psychological morbidity, and in particular PTSD symptoms, persists at least 3 months following pregnancy loss. Competing Interests: Conflicts of Interest: None declared. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
Databáze:	MEDLINE
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