TY - JOUR T1 - Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study JF - BMJ Open JO - BMJ Open DO - 10.1136/bmjopen-2016-011864 VL - 6 IS - 11 SP - e011864 AU - Jessica Farren AU - Maria Jalmbrant AU - Lieveke Ameye AU - Karen Joash AU - Nicola Mitchell-Jones AU - Sophie Tapp AU - Dirk Timmerman AU - Tom Bourne Y1 - 2016/11/01 UR - http://bmjopen.bmj.com/content/6/11/e011864.abstract N2 - Objectives This is a pilot study to investigate the type and severity of emotional distress in women after early pregnancy loss (EPL), compared with 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 1, 3 and 9 months after a diagnosis of EPL, and 1 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 email 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 3 months in the EPL group, and 20/50 in controls. Psychological morbidity was higher in the EPL group with 28% meeting the criteria for probable PTSD, 32% for anxiety and 16% for depression at 1 month and 38%, 20% and 5%, respectively, at 3 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 fulfil 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 3 months following pregnancy loss. ER -