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Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study
Sophiahemmet University.ORCID iD: 0000-0002-9672-7698
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2013 (English)In: BMJ open, ISSN 2044-6055, Vol. 3, no 10, e003323- p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: (1) To investigate the experiences of women with a previous stillbirth and their appraisal of the care they received at the hospital. (2) To assess the long-term level of post-traumatic stress symptoms (PTSS) in this group and identify risk factors for this outcome.

DESIGN: A retrospective study.

SETTING: Two university hospitals.

PARTICIPANTS: The study population comprised 379 women with a verified diagnosis of stillbirth (≥23 gestational weeks or birth weight ≥500 g) in a singleton or twin pregnancy 5-18 years previously. 101 women completed a comprehensive questionnaire in two parts.

PRIMARY AND SECONDARY OUTCOME MEASURES: The women's experiences and appraisal of the care provided by healthcare professionals before, during and after stillbirth. PTSS at follow-up was assessed using the Impact of Event Scale (IES).

RESULTS: The great majority saw (98%) and held (82%) their baby. Most women felt that healthcare professionals were supportive during the delivery (85.6%) and showed respect towards their baby (94.9%). The majority (91.1%) had received some form of short-term follow-up. One-third showed clinically significant long-term PTSS (IES ≥ 20). Independent risk factors were younger age (OR 6.60, 95% CI 1.99 to 21.83), induced abortion prior to stillbirth (OR 5.78, 95% CI 1.56 to 21.38) and higher parity (OR 3.46, 95% CI 1.19 to 10.07) at the time of stillbirth. Having held the baby (OR 0.17, 95% CI 0.05 to 0.56) was associated with less PTSS.

CONCLUSIONS: The great majority saw and held their baby and were satisfied with the support from healthcare professionals. One in three women presented with a clinically significant level of PTSS 5-18 years after stillbirth. Having held the baby was protective, whereas prior induced abortion was a risk factor for a high level of PTSS.

TRIAL REGISTRATION: The study was registered at http://www.clinicaltrials.gov, with registration number NCT 00856076.

Place, publisher, year, edition, pages
2013. Vol. 3, no 10, e003323- p.
Keyword [en]
Still birth, Posttraumatic stress symptoms, PTSS, Epidemiology
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:shh:diva-1537DOI: 10.1136/bmjopen-2013-003323PubMedID: 24154514OAI: oai:DiVA.org:shh-1537DiVA: diva2:698385
Available from: 2014-02-21 Created: 2014-02-21 Last updated: 2014-09-29Bibliographically approved

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