TY - JOUR
T1 - Severe postpartum hemorrhage increases risk of posttraumatic stress disorder
T2 - a prospective cohort study
AU - van Steijn, Minouk E
AU - Scheepstra, Karel W F
AU - Zaat, Tjitske R
AU - van Rooijen, Diana E
AU - Stramrood, Claire A I
AU - Dijksman, Lea M
AU - Valkenburg-van den Berg, Arijaan W
AU - Wiltenburg, Welmoed
AU - van der Post, Joris A M
AU - Olff, Miranda
AU - van Pampus, Maria G
N1 - Funding Information: We would like to thank all participants for participating and their interest in this topic. Furthermore, we would like to thank all participating hospitals (OLVG East and West, AMC, VUmc, Westfriesgasthuis, Flevoziekenhuis, Spaarne Gasthuis Haarlem and Hoofddorp) for including participants and their valuable contributions. Publisher Copyright: © 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Posttraumatic stress disorder
KW - severe postpartum hemorrhage
KW - subthreshold posttraumatic stress disorder
KW - traumatic birth
UR - http://www.scopus.com/inward/record.url?scp=85081718396&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/0167482X.2020.1735343
DO - https://doi.org/10.1080/0167482X.2020.1735343
M3 - Article
C2 - 32180491
SN - 0167-482X
VL - 42
SP - 335
EP - 345
JO - Journal of psychosomatic obstetrics and gynaecology
JF - Journal of psychosomatic obstetrics and gynaecology
IS - 4
ER -