Posttraumatic stress and posttraumatic stress disorder after termination of pregnancy and reproductive loss: a systematic review.

Viltė Daugirdaitė,Olga Van Den Akker,Satvinder Purewal

doi:10.1155/2015/646345

Viltė Daugirdaitė, Olga Van Den Akker + Show 1 more

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https://doi.org/10.1155/2015/646345

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Abstract

Objective. The aims of this systematic review were to integrate the research on posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after termination of pregnancy (TOP), miscarriage, perinatal death, stillbirth, neonatal death, and failed in vitro fertilisation (IVF). Methods. Electronic databases (AMED, British Nursing Index, CINAHL, MEDLINE, SPORTDiscus, PsycINFO, PubMEd, ScienceDirect) were searched for articles using PRISMA guidelines. Results. Data from 48 studies were included. Quality of the research was generally good. PTS/PTSD has been investigated in TOP and miscarriage more than perinatal loss, stillbirth, and neonatal death. In all reproductive losses and TOPs, the prevalence of PTS was greater than PTSD, both decreased over time, and longer gestational age is associated with higher levels of PTS/PTSD. Women have generally reported more PTS or PTSD than men. Sociodemographic characteristics (e.g., younger age, lower education, and history of previous traumas or mental health problems) and psychsocial factors influence PTS and PTSD after TOP and reproductive loss. Conclusions. This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss.

Highlights

Posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after reproductive loss have not been well recognised, despite the growing documentation of adverse psychological states associated with reproductive losses
The classification of termination of pregnancy (TOP) and reproductive loss varies from country to country [1], TOP broadly refers to the termination of a clinical pregnancy and miscarriage to the spontaneous loss of a clinical pregnancy before 20 completed weeks of gestation
In PubMEd, the following key words were used in title/abstract search: “miscarriage” or “stillbirth” or “abortion” or “neonatal death” or “perinatal loss” or “failed in vitro fertilisation (IVF)” or “failed in vitro fertilization” or “failed in vitro fertilization” or “pregnancy loss” or “termination of pregnancy” and “trauma” or “stress” or “PTSD” or “posttraumatic stress,” or “posttraumatic stress disorder.”

Summary

Introduction

Posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after reproductive loss have not been well recognised, despite the growing documentation of adverse psychological states associated with reproductive losses. The classification of TOP and reproductive loss varies from country to country [1], TOP broadly refers to the termination of a clinical pregnancy and miscarriage to the spontaneous loss of a clinical pregnancy before 20 completed weeks of gestation. On the other hand, refers to a fetal or neonatal death after 20+ weeks during pregnancy and childbirth or up to 7 days after birth, whereas stillbirth denotes the death of a (20+ weeks of gestational age) baby before the complete expulsion/extraction from its mother. A neonatal death is said to have occurred when a live born baby dies within 28 days of birth [2]. PTS and PTSD can evolve after any of these reproductive losses [7,8,9,10]

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Conclusion