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Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study
  1. Ida Kathrine Gravensteen1,2,3,
  2. Linda Björk Helgadóttir1,4,
  3. Eva-Marie Jacobsen1,3,
  4. Ingela Rådestad5,
  5. Per Morten Sandset1,3,
  6. Øivind Ekeberg2,6
  1. 1Department of Haematology, Oslo University Hospital, Oslo, Norway
  2. 2Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
  3. 3Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  4. 4Department of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
  5. 5Sophiahemmet University, Stockholm, Sweden
  6. 6Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
  1. Correspondence to Dr Eva-Marie Jacobsen; e.m.jacobsen{at}medisin.uio.no

Abstract

Objectives (1) To investigate the experiences of women with a previous stillbirth and their appraisal of the care they received at the hospital. (2) To assess the long-term level of post-traumatic stress symptoms (PTSS) in this group and identify risk factors for this outcome.

Design A retrospective study.

Setting Two university hospitals.

Participants The study population comprised 379 women with a verified diagnosis of stillbirth (≥23 gestational weeks or birth weight ≥500 g) in a singleton or twin pregnancy 5–18 years previously. 101 women completed a comprehensive questionnaire in two parts.

Primary and secondary outcome measures The women's experiences and appraisal of the care provided by healthcare professionals before, during and after stillbirth. PTSS at follow-up was assessed using the Impact of Event Scale (IES).

Results The great majority saw (98%) and held (82%) their baby. Most women felt that healthcare professionals were supportive during the delivery (85.6%) and showed respect towards their baby (94.9%). The majority (91.1%) had received some form of short-term follow-up. One-third showed clinically significant long-term PTSS (IES ≥ 20). Independent risk factors were younger age (OR 6.60, 95% CI 1.99 to 21.83), induced abortion prior to stillbirth (OR 5.78, 95% CI 1.56 to 21.38) and higher parity (OR 3.46, 95% CI 1.19 to 10.07) at the time of stillbirth. Having held the baby (OR 0.17, 95% CI 0.05 to 0.56) was associated with less PTSS.

Conclusions The great majority saw and held their baby and were satisfied with the support from healthcare professionals. One in three women presented with a clinically significant level of PTSS 5–18 years after stillbirth. Having held the baby was protective, whereas prior induced abortion was a risk factor for a high level of PTSS.

Trial registration The study was registered at http://www.clinicaltrials.gov, with registration number NCT 00856076.

  • Epidemiology

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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