Perinatal loss is a traumatic event for women and their families.  While we clearly understand the potential for perinatal loss to cause significant emotional consequences, we have little data on the prevalence of depressive illness and posttraumatic stress disorder in this population of women.

A recent study contacted a total of 1400 women with stillbirth or an infant death before 28 days of age. 609 women completed surveys and were eligible to participate (44% response rate).  On average, the women complete surveys on average 9 months after the loss.  The cohort included 377 bereaved mothers and a comparison group of 232 mothers with live births.

Compared to women who had a live birth, women who had experienced a perinatal loss had a nearly 4-fold higher odds of having a positive screen for depression and a 7-fold higher odds of a positive screen for post-traumatic stress disorder after controlling for demographic and personal risk variables.

In this analysis, prior history of depressive disorder, prior PTSD, and intimate partner violence (IPV) were all independent predictors of depressive and PTSD symptoms after a perinatal loss. For depression, the odds ratios for these variables were as follows: prior depression, OR 3.19 (CI 1.85–5.50, p<0.0005); prior PTSD, OR 3.43 (CI 1.69–6.96); IPV, OR 2.01 (CI 1.03–3.92,p=0.040). For PTSD symptoms: prior depression, OR 3.72 (CI:2.34-4.93,p<0.0005); prior PTSD, OR 2.96 (CI 1.42–6.17, p=0.004); IPV, OR 2.12 (CI 1.09–4.13, p=0.027).

To date this is the largest epidemiologically based study measuring the psychological impact of perinatal loss.  Nine months (on average) after a perinatal loss, bereaved women showed high levels of psychological distress.  At greatest risk for depression and PTSD were women with a prior history of depression or PTSD and exposure to intimate partner violence.  Despite the prevalence and persistence of these symptoms, only a minority of women were receiving any type of psychiatric treatment.

Ruta Nonacs, MD PhD

Gold KJ, Leon I, Boggs ME, Sen A.  Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample.  J Womens Health (Larchmt). 2015 Aug 10. [Epub ahead of print]