Postpartum haemorrhage deals long-term psychological harms to women, partners

The long-term risk of psychological adverse outcomes after postpartum haemorrhage (PPH) is high among women and their partners, a recent study has found.

Researchers enrolled 63 severe PPH patients who had been treated with uterine artery embolization (UAE), as well as 189 matched controls. Psychological outcomes were assessed using the trauma screening questionnaire (TSQ) and mini-international neuropsychiatric interview (MINI). Mean follow-up was 8.1 years.

PPH patients were at a significantly higher risk of symptoms of depression than comparators with uneventful deliveries (MINI score; p=0.015). PPH patients were also more likely to have depressed mood (p=0.043), have motor disorders (p=0.003), be tired (p=0.047), and lose interest in most things (p=0.05). Appetite, sleeping disorders, and feelings of guilt or worthlessness did not differ between groups.

In terms of post-traumatic stress, TSQ scores were likewise significantly higher in PPH patients than controls (p<0.001). Patients with PPH were more likely to act as though their episode was happening again (p=0.006) or to be upset at being reminded of the PPH (p<0.001). They also had more frequent upsetting thoughts or memories (p<0.001).

Post-traumatic stress disorder (PTSD) was documented in 22.2 percent and 4.8 percent of women with vs without PPH (p<0.001). PPH was significantly correlated with PTSD even after controlling for maternal depression (adjusted odds ratio, 5.1, 95 percent confidence interval, 1.5–17.5).

Among the participants’ partners, depression (p=0.029) and PTSD (p=0.019) were also more likely in the PPH vs control group.