Prevalence of maternal psychological disorders after immediate
postpartum haemorrhage: a repeated cross-sectional survey in a cohort
study
Abstract
Objective To assess depression at 2(M2), 6(M6), and 12(M12) postpartum
months among women with postpartum haemorrhage (PPH) compared with women
with no PPH and, to describe anxiety and post-traumatic stress disorder
(PTSD). Design Repeated cross-sectional study within a prospective
cohort of women in the immediate postpartum period. Setting
Single-centre study at a French level 3 maternity unit. Population Women
who gave birth at ≥22 weeks of gestation were eligible. The exposed
group comprised the women who had had a primary PPH (≥500 mL in the 24
hours after delivery) and the unexposed group, which did not. Methods
1298 included women (528 with and 770 without PPH) completed
self-administered questionnaires. Main Outcome Measures The prevalence
of depression and its mean scores, at M2, M6, and M12 and secondary, the
prevalence of anxiety and of PTSD and its mean scores, measured at the
same times. Results At M2, the prevalence of depression and PTSD was
higher among the women with PPH (24.4% vs 18.2%, p=0.03, and 12.8% vs
7.6%, p=0.02). The prevalence of anxiety at inclusion and M2 was higher
in the PPH group (18.1% vs 10.3%, p=0.01, and 20.0% vs 13.3%,
p=0.01). At M6, and M12, only the mean adjusted PTSD score was higher in
the PPH group (7.6, 95%CI, 6.3-9.1 vs 5.8%, 95%CI, 4.9-6.8, p=0.02).
Conclusions Professionals must know these high rates and screen for
psychological disorders during the long postpartum period. Funding Grant
from the Clermont-Ferrand University Hospital AOI2015. Keywords
Postpartum haemorrhage; depression; anxiety; post-traumatic stress
disorder, psychological disorder