Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study

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Title: Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study
Authors: Farren, JA
Jalmbrant, M
Ameye, L
Joash, K
Mitchell-Jones, N
Tapp, S
Timmerman, D
Bourne, T
Item Type: Journal Article
Abstract: Objectives: This is a pilot study to investigate the type and severity of emotional distress in women after early pregnancy loss (EPL), compared to a control group with ongoing pregnancies. The secondary aim was to assess whether miscarriage or ectopic pregnancy impacted differently on the type and severity of psychological morbidity. Design: This was a prospective survey study. Consecutive women were recruited between January 2012 and July 2013. We emailed women a link to a survey one, three and nine months after a diagnosis of EPL, and one month after the diagnosis of a viable ongoing pregnancy. Setting: The Early Pregnancy Assessment Unit (EPAU) of a central-London teaching hospital Participants: We recruited 186 women. 128 had a diagnosis of EPL, and 58 of ongoing pregnancies. 11 withdrew consent, and 11 provided an illegible or invalid e-mail address. Main outcome measures: Post-traumatic stress disorder (PTSD) was measured using the Post-traumatic Diagnostic Scale (PDS), and Anxiety and Depression using the Hospital Anxiety and Depression Scale (HADS) Results: Response rates were 69/114 at 1 month and 44/68 at three months in the EPL group, and 20/50 in controls. Psychological morbidity was higher in the EPL group with 28% meeting criteria for probable PTSD, 32% for anxiety, and 16% for depression at one month and 38%, 20%, and 5% respectively at three months. In the control group, no women met criteria for PTSD and 10% met criteria for anxiety and depression. There was little difference in type or severity of distress following ectopic pregnancy or miscarriage. Conclusions: We have shown a large number of women having experienced a miscarriage or ectopic pregnancy fulfill the diagnostic criteria for probable PTSD. Many suffer from moderate to severe anxiety, and a lesser number depression. Psychological morbidity, and in particular PTSD symptoms, persists at least three months following pregnancy loss.
Issue Date: 2-Nov-2016
Date of Acceptance: 16-Aug-2016
ISSN: 2044-6055
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ Open
Volume: 6
Issue: 11
Copyright Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Sponsor/Funder: Imperial College Healthcare Charity
Funder's Grant Number: 141517
Publication Status: Published
Article Number: e011864
Appears in Collections:Division of Surgery
Faculty of Medicine

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