Department of Obstetrics and Gynecology, OLVG, Amsterdam, the Netherlands.
Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
J Psychosom Obstet Gynaecol. 2021 Dec;42(4):335-345. doi: 10.1080/0167482X.2020.1735343. Epub 2020 Mar 17.
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.
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.
We included 187 PPH patients and 121 controls. Median PCL-5 scores were higher for PPH patients (5.0) than controls (4.0, = 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, = 0.035). Significant more PPH patients than controls met criteria for a clinical diagnosis of PTSD on the CAPS-5 ( = 10, 5.6% vs = 0, 0.0%; = 0.007).
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.
NL50273.100.14.
评估严重产后出血（PPH）是否是创伤后应激障碍（PTSD）的危险因素。严重 PPH 可被视为创伤性事件。PTSD 会导致负面的心理健康影响。了解分娩时 PTSD 的危险因素可为早期干预提供机会，从而可能预防 PTSD 的发生。
在这项前瞻性研究中，我们比较了两组参与者；出血量≥2000ml（严重 PPH，患者）和出血量≤500ml（对照组）的女性。产后四至六周，使用 PCL-5 对参与者进行 PTSD 筛查。阳性筛查后，采用 CAPS-5 对 PTSD 进行诊断。
我们纳入了 187 例 PPH 患者和 121 例对照组。PPH 患者的 PCL-5 中位数评分（5.0）高于对照组（4.0， = 0.005）。13 例 PPH 患者（7.0%）和 2 例对照组（1.7%）PCL-5 评分≥32，提示可能患有 PTSD（OR 4.45，95%CI 0.99-20.06， = 0.035）。在 CAPS-5 上，PPH 患者符合 PTSD 临床诊断标准的人数明显多于对照组（ = 10，5.6% vs = 0，0.0%； = 0.007）。
严重 PPH 后发生 PTSD 的风险显著增加，且具有临床相关性。妇科医生和助产士应在产后随访时对 PTSD 进行筛查，以预防长期的负面心理健康影响。
NL50273.100.14.
