Severe postpartum hemorrhage increases risk of posttraumatic stress disorder: a prospective cohort study.

Autor: van Steijn ME; Department of Obstetrics and Gynecology, OLVG, Amsterdam, the Netherlands.; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., Scheepstra KWF; Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., Zaat TR; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., van Rooijen DE; Department of Research and Epidemiology, OLVG, Amsterdam, the Netherlands., Stramrood CAI; Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands., Dijksman LM; Department of Epidemiology and Statistics, St Antonius Hospital, the Netherlands., Valkenburg-van den Berg AW; Department of Obstetrics and Gynecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands., Wiltenburg W; Department of Obstetrics and Gynecology, Westfriesgasthuis, the Netherlands., van der Post JAM; Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., Olff M; Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.; Arq Psychotrauma Expert Group, Diemen, The Netherlands., van Pampus MG; Department of Obstetrics and Gynecology, OLVG, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Journal of psychosomatic obstetrics and gynaecology [J Psychosom Obstet Gynaecol] 2021 Dec; Vol. 42 (4), pp. 335-345. Date of Electronic Publication: 2020 Mar 17.
DOI: 10.1080/0167482X.2020.1735343
Abstrakt: Purpose: To evaluate whether severe postpartum hemorrhage (PPH) is a risk factor for posttraumatic stress disorder (PTSD). Severe PPH can be experienced as a traumatic event. PTSD leads to negative mental health effects. Knowing risk factors for PTSD during childbirth offers opportunities for early interventions, which may prevent the development of PTSD.
Materials and Methods: In this prospective study, we compared two groups of participants; women with ≥2000 mL of blood loss (severe PPH, patients) and women with ≤500 mL of blood loss (controls). Participants were screened for PTSD using the PCL-5 four to six weeks after delivery. Positive screening was followed by the CAPS-5 to diagnose PTSD.
Results: We included 187 PPH patients and 121 controls. Median PCL-5 scores were higher for PPH patients (5.0) than controls (4.0, p  = 0.005). Thirteen PPH patients (7.0%) and two controls (1.7%) scored ≥32 on the PCL-5, indicative of probable PTSD (OR 4.45, 95% CI 0.99-20.06, p  = 0.035). Significant more PPH patients than controls met criteria for a clinical diagnosis of PTSD on the CAPS-5 ( n  = 10, 5.6% vs n  = 0, 0.0%; p  = 0.007).
Conclusions: There is a significant and clinically relevant increased risk for developing PTSD after severe PPH. Gynecologists and midwives are advised to screen for PTSD at postpartum follow-up visits to prevent long-term negative mental health effects.
Clinical Trial Registration: NL50273.100.14.
Databáze: MEDLINE
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