THE PREVALENCE of post-traumatic stress disorder (PTSD) symptoms in women who have experienced an early pregnancy loss has surprised scientists and prompted suggestions for the need of routine screening of the disorder after miscarriage or ectopic pregnancy.
In the new study, Dr Jessica Farren from the Imperial College of London and her team have shown that a significant number of women with an early pregnancy loss also had probable PTSD. The team sent questionnaires to women 1 month and 3 months after they were diagnosed with the pregnancy loss at Queen Charlotte’s and Chelsea Hospital, London, UK. At 1 month, 69 women responded to the questionnaire which assessed the levels of post-traumatic stress, and 44 responded again at 3 months.
The team found that at 1 month, 19 out of the 69 women met the diagnostic criteria for probable moderate or severe PTSD. At 3 months, 17 out the 44 women continued to meet the criteria. In a small control group of 20 women who responded to the questionnaire and had viable and ongoing pregnancies, none met the criteria for a diagnosis of probable PTSD.
“We were surprised by the prevalence of PTSD symptoms in our study,” the team explained. “Even in women not meeting the full criteria for PTSD, there was a significant endorsement of all symptom clusters by the majority of participants.” At both 1 and 3 months, the most common symptom cluster was found to be women ‘re-experiencing’ their loss. At 1 month, the most commonly endorsed statement from the questionnaire was: ‘feeling emotionally upset when you were reminded of the loss of your pregnancy’. Out of 69 women, 40 reported this happening at least 2–4 times per week.
The researchers explained that one aim of the study was to assess the feasibility of conducting future studies with larger sample sizes to assess the risk factors involved in PTSD after a pregnancy loss. They said: “If our findings are supported by further large prospective studies, we believe that consideration should be given to screening all women who have suffered an [early pregnancy loss] for PTSD.” Dr Farren told the EMJ: “Screening could take place via a GP appointment at 6 weeks (similar to a postnatal check after a healthy pregnancy), though this would obviously pose a not insignificant workload.”
Jack Redden, Reporter
