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Posttraumatic Stress Disorder Symptoms and Related Factors in Women with Early Pregnancy Loss

Year 2022, , 884 - 890, 30.11.2022
https://doi.org/10.16899/jcm.1165862

Abstract

Aim: Women may experience emotions such as fear, anxiety, stress, anger or guilt after pregnancy loss, and it can lead to posttraumatic stress disorder if the women cannot cope with these emotions. This study aimed to identify posttraumatic stress disorder symptoms and related factors in women with early pregnancy loss.
Material and Methods: The sample of this descriptive study consisted of 132 women hospitalised with early pregnancy loss in an Obstetrics and Gynecology service of a state hospital (<20 weeks). Data were collected using the Personal Information Form, Posttraumatic Stress Disorder Checklist - Civilian Version, the State-Trait Anxiety Inventory and the the Ways of Coping with Stress Scale.
Results: Posttraumatic stress disorder (PTSD) symptoms were found in 62.9% of the women. As women’s PTSD symptoms increased, their state and trait anxiety also increased (r=0.692–0.752; p<0.01). As the symptoms of PTSD decreased, the scores of self-confidence, optimism, and search for social support approaches increased, and as the symptoms increased, the scores of the desperate and submissive approaches increased (r=0.246–0.579; p<0.01).
Conclusion: PTSD symptoms are high in women after pregnancy loss. SAI, TAI, desperate, submissive and social support, health status, and wanted pregnancy variables are associated with PTSD.

Supporting Institution

Yok

Project Number

Yok

Thanks

As authors, we would like to thank the fathers who agreed to participate in the research.

References

  • Referans1 Engelhard IM, van den Hout MA, Schouten EG. Neuroticism and low educational level predict the risk of posttraumatic stress disorder in women after miscarriage or stillbirth. Gen Hosp Psychiatry 2006; 28: 414–417. doi:10.1016/j.genhosppsych.2006.07.001
  • Referans2 Farren J, Mitchell-Jones N, Verbakel JY, et al. The psychological impact of early pregnancy loss. Hum Reprod Update 2018; 24: 731–749. doi:10.1093/humupd/dmy025
  • Referans3 Horesh D, Nukrian M, Bialik Y. To lose an unborn child: post-traumatic stress disorder and major depressive disorder following pregnancy loss among Israeli women. Gen Hosp Psychiatry 2018; 53: 95–100. doi:10.1016/j.genhosppsych.2018.02.003
  • Referans4 Carter D, Misri S, Tomfohr L. Psychologic aspects of early pregnancy. Clin Obstet Gynecol 2007; 50:154–165. doi:10.1097/GRF.0b013e31802f1d28
  • Referans5 Keten HS, Gencoglan S, Dalgacı AF, et al. Evaluation of acute stress disorder following pregnancy losses. Cukurova Medical Journal 2015; 40: 226–232. doi:10.17826/cutf.79332
  • Referans6 Białek KI, Malmur M. Risk of post-traumatic stress disorder in women after miscarriage. Medical Studies 2020; 36: 134–141. doi: 10.5114/ms.2020.96794
  • Referans7 Farren J, Jalmbrant M, Falconieri N, et al. Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study. Am J Obstet Gynecol 2020; 222: 367. doi:10.1016/j.ajog.2019.10.102
  • Referans8 Coleman PK, Coyle CT, Rue VM. Late-term elective abortion and susceptibility to posttraumatic stress symptoms. J Pregnancy 2010; 2010: 130519. doi:10.1155/2010/130519
  • Referans9 Farren J, Jalmbrant M, Falconieri N, et al. Differences in post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy between women and their partners: multicenter prospective cohort study.Ultrasound Obstet Gynecol 2021; 57:141-148. doi: 10.1002/uog.23147
  • Referans10 Rousset C, Brulfert C, Séjourné N, et al. Posttraumatic stress disorder and psychological distress following medical and surgical abortion. Journal of Reproductive and Infant Psychology 2011; 29: 506–517. doi:10.1080/02646838.2012.654489
  • Referans11 Zhu CS, Tan TC, Chen HY, et al. Threatened miscarriage and depressive and anxiety symptoms among women and partners in early pregnancy. J Affect Disord 2018; 237: 1–9. doi: 10.1016/j.jad.2018.04.012
  • Referans12 Faramarzi M, Amiri FN, Rezaee R. Relationship of coping ways and anxiety with pregnancy specific-stress.Pak J Med Sci 2016; 32, 1364–1369. doi:10.12669/pjms.326.10892
  • Referans13 Kicia M, Skurzak A, Wiktor K, et al. Anxiety and stress in miscarriage. Pol J Public Health 2015; 125: 162–165. doi:10.1515/pjph-2015-0046
  • Referans14 Abiola L, Legendre G, Spiers A, et al. Late fetal demise, a risk factor for post traumatic stress disorder. Scientifc Reports 2022; 12: 12364. doi: 10.1038/s41598-022-16683-5
  • Referans15 Christiansen DM. Posttraumatic stress disorder in parents following in-fant death: a systematic review. Clin Psychol Rev 2017; 51: 60–74. doi:10.1016/j.cpr.2016.10.007
  • Referans16 Farren J, Jalmbrant M, Ameye L, et al. Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. BMJ Open 2016; 6: e011864. doi:10.1136/bmjopen-2016-011864
  • Referans17 Guclu OG, Arslan O, Erkıran M, et al. The relationship of temperament and character profiles with posttraumatic stress disorder in women undergoing termination of pregnancy for fetal anomaly.Archives of Neuropsychiatry 2013; 50: 161–168. doi: 10.4274/npa.y6377
  • Referans18 Weathers FW, Litz BT, Herman DS, et al. The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the 9th annual meeting of the International Society for Traumatic Stress Studies, Austin, TX, 1993.
  • Referans19 Kocabasoglu N, Corapcıoglu Ozdemir A, Yargıc I, et al. The validity and safety of Turkish “PTSD Checkust-Civilian Version” (PCL-C) Scale. Yeni Symposium 2005; 43: 126–134.
  • Referans20 Spielberger CD, Gorsuch RC, Luschene RE. Manual for the State‐Trait Anxiety Inventory. California: Consulting Psychologists Press, 1970.
  • Referans21 Oner N, Lecompte A. State and Trait Anxiety Inventory Handbook. Istanbul/Turkey: Boğaziçi University Publications, 1983.
  • Referans22 Folkman S, Lazarus RS. An analysis of coping in a middle-aged community sample. J Health Soc Behav 1980; 21: 219–239.
  • Referans23 Hisli Sahin N, Durak A. Stress coping styles scale: adaptation for university students. Turkish Journal of Psychology 1995; 10: 56–73.
  • Referans24 Fernández-Ordoñez E, González-Cano-Caballero M, Guerra-Marmolejo C, et al. Perinatal grief and post-traumatic stress disorder in pregnancy after perinatal loss: a longitudinal study protocol.International Journal of Environmental Research and Public Health 2021; 18: 2874. doi:10.3390/ijerph18062874
  • Referans25 Burden C, Bradley S, Storey C, et al. From grief, guilt pain and stigma to hope and pride-a system-atic review and meta-analysis of mixed-method research of the psychosocial impact of stillbirth. BMC Pregnancy and Childbirth 2016; 16: 1–12. doi:10.1186/s12884-016-0800-8
  • Referans26 Ridaura I, Penelo E, Raich RM. Depressive symptomatology and grief in Spanish women who have suffered a perinatal loss.Psicothema 2017; 29: 43–48. doi:10.7334/psicothema2016.151
  • Referans27 Westby CL, Erlandsen AR, Nilsen SA, et al. Depression, anxiety, PTSD, and OCD after stillbirth: a systematic review. BMC Pregnancy and Childbirth 2021; 21: 782. doi:10.1186/s12884-021-04254-x
  • Referans28 Fernández-Ordoñez E, Rengel Díaz C, Morales Gil IM, et al. Post-traumatic stress disorder after subsequent birth to a gestational loss: an observational study. Salud Mental 2020; 43: 129-136. doi:10.17711/SM.0185-3325.2020.018
  • Referans29 Cumming G, Klein S, Bolsover D, et al. The emotional burden of miscarriage for women and their partners: trajectories of anxiety and depression over 13 months. BJOG 2007; 114: 1138–1145. doi:10.1111/j.1471-0528.2007.01452.x
  • Referans30 Palas Karaca P, Yesiltepe Oskay U. Effect of supportive care on the psychosocial health status of women who had a miscarriage. Perspect Psychiatr Care 2020; 1–10. doi:10.1111/ppc.12540
  • Referans31 Bergner A, Beyer R, Klapp BF, et al. Pregnancy after early pregnancy loss: a prospective study of anxiety, depressive symptomatology and coping. J Psychosom Obstet Gynaecol 2008; 29: 105–113. doi:10.1080/01674820701687521
  • Referans32 Aydin Kartal Y, Yesiltepe Oskay U. Anxiety, depression and coping with stress styles of pregnant women with preterm labor risk. International Journal of Caring Sciences 2017; 10: 716–725.
  • Referans33 Loh J, Harms C, Harman B. Effects of parental stress, optimism, and health-promoting behaviors on the quality of life of primiparous and multiparous mothers. Nurs Res 2017; 66:231–239. doi:10.1097/NNR.0000000000000219
  • Referans34 Aghaei A, Khayyamnekouei Z, Yousefy A. General health prediction based on life orientation, quality of life, life satisfaction and age. Procedia-Social and Behavioral Sciences 2013; 84:569-573. doi:10.1016/j.sbspro.2013.06.605
  • Referans35 Kabalcıoğlu Bucak F, Toker E, Asoğlu M. Women who apply therapeutic abortus’ state and trait anxiety levels and related factors.Journal of Health Academics 2018; 5: 256-263. doi:10.5455/sad.13-1543399784
  • Referans36 Mukkavaara I, Öhrling K, Lindberg I. Women’s experiences after an induced second trimester abortion.Midwifery. 2012; 28: e720-725. doi:10.1016/j.midw.2011.07.011

Erken Gebelik Kaybı Yaşayan Kadınlarda Posttravmatik Stres Bozukluğu Belirtileri ve İlişkili Faktörler

Year 2022, , 884 - 890, 30.11.2022
https://doi.org/10.16899/jcm.1165862

Abstract

Amaç: Gebelik kaybı sonrası kadınlar korku, kaygı, stres, öfke veya suçluluk gibi duygular yaşayabilir ve bu duygularla baş edemezse posttravmatik stres bozukluğuna yol açabilir. Çalışmada erken gebelik kaybı yaşayan kadınlarda posttravmatik stres bozukluğu belirtileri ve ilişkili faktörlerin belirlenmesi amaçlanmıştır.
Gereç ve Yöntem: Tanımlayıcı türdeki araştırmanın örneklemini bir devlet hastanesinin Kadın Hastalıkları ve Doğum Servisi’ne erken gebelik kaybı ile yatan (<20 hafta) 132 kadın oluşturmuştur. Veriler Kişisel Bilgi Formu, Postravmatik Stres Bozukluğu Soru Listesi-Sivil Versiyonu, Durumluk-Sürekli Kaygı Envanteri ve Stres ile Başa Çıkma Tarzları Ölçeği kullanılarak toplanmıştır.
Bulgular: Kadınlarda posttravmatik stres bozukluğu (PTSB) belirtileri %62.9’dur. PTSB belirtileri arttıkça durumluk ve sürekli kaygı da artmaktadır (r=0.692-0.752; p<0.01). PTSB belirtileri azaldıkça kendine güvenli, iyimser ve sosyal destek arama yaklaşımı puanları; belirtiler arttıkça da çaresiz ve boyun eğici yaklaşım puanları artmaktadır (r=0.246-0.579; p<0.01).
Sonuç: Gebelik kaybı sonrası kadınların PTSB belirtileri yüksektir. Durumluk, sürekli kaygı, çaresiz, boyun eğici ve sosyal destek arama yaklaşımı ile sağlık durumu, istenen gebelik durumu PTSB belirtileri ile ilişkilidir.

Project Number

Yok

References

  • Referans1 Engelhard IM, van den Hout MA, Schouten EG. Neuroticism and low educational level predict the risk of posttraumatic stress disorder in women after miscarriage or stillbirth. Gen Hosp Psychiatry 2006; 28: 414–417. doi:10.1016/j.genhosppsych.2006.07.001
  • Referans2 Farren J, Mitchell-Jones N, Verbakel JY, et al. The psychological impact of early pregnancy loss. Hum Reprod Update 2018; 24: 731–749. doi:10.1093/humupd/dmy025
  • Referans3 Horesh D, Nukrian M, Bialik Y. To lose an unborn child: post-traumatic stress disorder and major depressive disorder following pregnancy loss among Israeli women. Gen Hosp Psychiatry 2018; 53: 95–100. doi:10.1016/j.genhosppsych.2018.02.003
  • Referans4 Carter D, Misri S, Tomfohr L. Psychologic aspects of early pregnancy. Clin Obstet Gynecol 2007; 50:154–165. doi:10.1097/GRF.0b013e31802f1d28
  • Referans5 Keten HS, Gencoglan S, Dalgacı AF, et al. Evaluation of acute stress disorder following pregnancy losses. Cukurova Medical Journal 2015; 40: 226–232. doi:10.17826/cutf.79332
  • Referans6 Białek KI, Malmur M. Risk of post-traumatic stress disorder in women after miscarriage. Medical Studies 2020; 36: 134–141. doi: 10.5114/ms.2020.96794
  • Referans7 Farren J, Jalmbrant M, Falconieri N, et al. Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study. Am J Obstet Gynecol 2020; 222: 367. doi:10.1016/j.ajog.2019.10.102
  • Referans8 Coleman PK, Coyle CT, Rue VM. Late-term elective abortion and susceptibility to posttraumatic stress symptoms. J Pregnancy 2010; 2010: 130519. doi:10.1155/2010/130519
  • Referans9 Farren J, Jalmbrant M, Falconieri N, et al. Differences in post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy between women and their partners: multicenter prospective cohort study.Ultrasound Obstet Gynecol 2021; 57:141-148. doi: 10.1002/uog.23147
  • Referans10 Rousset C, Brulfert C, Séjourné N, et al. Posttraumatic stress disorder and psychological distress following medical and surgical abortion. Journal of Reproductive and Infant Psychology 2011; 29: 506–517. doi:10.1080/02646838.2012.654489
  • Referans11 Zhu CS, Tan TC, Chen HY, et al. Threatened miscarriage and depressive and anxiety symptoms among women and partners in early pregnancy. J Affect Disord 2018; 237: 1–9. doi: 10.1016/j.jad.2018.04.012
  • Referans12 Faramarzi M, Amiri FN, Rezaee R. Relationship of coping ways and anxiety with pregnancy specific-stress.Pak J Med Sci 2016; 32, 1364–1369. doi:10.12669/pjms.326.10892
  • Referans13 Kicia M, Skurzak A, Wiktor K, et al. Anxiety and stress in miscarriage. Pol J Public Health 2015; 125: 162–165. doi:10.1515/pjph-2015-0046
  • Referans14 Abiola L, Legendre G, Spiers A, et al. Late fetal demise, a risk factor for post traumatic stress disorder. Scientifc Reports 2022; 12: 12364. doi: 10.1038/s41598-022-16683-5
  • Referans15 Christiansen DM. Posttraumatic stress disorder in parents following in-fant death: a systematic review. Clin Psychol Rev 2017; 51: 60–74. doi:10.1016/j.cpr.2016.10.007
  • Referans16 Farren J, Jalmbrant M, Ameye L, et al. Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. BMJ Open 2016; 6: e011864. doi:10.1136/bmjopen-2016-011864
  • Referans17 Guclu OG, Arslan O, Erkıran M, et al. The relationship of temperament and character profiles with posttraumatic stress disorder in women undergoing termination of pregnancy for fetal anomaly.Archives of Neuropsychiatry 2013; 50: 161–168. doi: 10.4274/npa.y6377
  • Referans18 Weathers FW, Litz BT, Herman DS, et al. The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the 9th annual meeting of the International Society for Traumatic Stress Studies, Austin, TX, 1993.
  • Referans19 Kocabasoglu N, Corapcıoglu Ozdemir A, Yargıc I, et al. The validity and safety of Turkish “PTSD Checkust-Civilian Version” (PCL-C) Scale. Yeni Symposium 2005; 43: 126–134.
  • Referans20 Spielberger CD, Gorsuch RC, Luschene RE. Manual for the State‐Trait Anxiety Inventory. California: Consulting Psychologists Press, 1970.
  • Referans21 Oner N, Lecompte A. State and Trait Anxiety Inventory Handbook. Istanbul/Turkey: Boğaziçi University Publications, 1983.
  • Referans22 Folkman S, Lazarus RS. An analysis of coping in a middle-aged community sample. J Health Soc Behav 1980; 21: 219–239.
  • Referans23 Hisli Sahin N, Durak A. Stress coping styles scale: adaptation for university students. Turkish Journal of Psychology 1995; 10: 56–73.
  • Referans24 Fernández-Ordoñez E, González-Cano-Caballero M, Guerra-Marmolejo C, et al. Perinatal grief and post-traumatic stress disorder in pregnancy after perinatal loss: a longitudinal study protocol.International Journal of Environmental Research and Public Health 2021; 18: 2874. doi:10.3390/ijerph18062874
  • Referans25 Burden C, Bradley S, Storey C, et al. From grief, guilt pain and stigma to hope and pride-a system-atic review and meta-analysis of mixed-method research of the psychosocial impact of stillbirth. BMC Pregnancy and Childbirth 2016; 16: 1–12. doi:10.1186/s12884-016-0800-8
  • Referans26 Ridaura I, Penelo E, Raich RM. Depressive symptomatology and grief in Spanish women who have suffered a perinatal loss.Psicothema 2017; 29: 43–48. doi:10.7334/psicothema2016.151
  • Referans27 Westby CL, Erlandsen AR, Nilsen SA, et al. Depression, anxiety, PTSD, and OCD after stillbirth: a systematic review. BMC Pregnancy and Childbirth 2021; 21: 782. doi:10.1186/s12884-021-04254-x
  • Referans28 Fernández-Ordoñez E, Rengel Díaz C, Morales Gil IM, et al. Post-traumatic stress disorder after subsequent birth to a gestational loss: an observational study. Salud Mental 2020; 43: 129-136. doi:10.17711/SM.0185-3325.2020.018
  • Referans29 Cumming G, Klein S, Bolsover D, et al. The emotional burden of miscarriage for women and their partners: trajectories of anxiety and depression over 13 months. BJOG 2007; 114: 1138–1145. doi:10.1111/j.1471-0528.2007.01452.x
  • Referans30 Palas Karaca P, Yesiltepe Oskay U. Effect of supportive care on the psychosocial health status of women who had a miscarriage. Perspect Psychiatr Care 2020; 1–10. doi:10.1111/ppc.12540
  • Referans31 Bergner A, Beyer R, Klapp BF, et al. Pregnancy after early pregnancy loss: a prospective study of anxiety, depressive symptomatology and coping. J Psychosom Obstet Gynaecol 2008; 29: 105–113. doi:10.1080/01674820701687521
  • Referans32 Aydin Kartal Y, Yesiltepe Oskay U. Anxiety, depression and coping with stress styles of pregnant women with preterm labor risk. International Journal of Caring Sciences 2017; 10: 716–725.
  • Referans33 Loh J, Harms C, Harman B. Effects of parental stress, optimism, and health-promoting behaviors on the quality of life of primiparous and multiparous mothers. Nurs Res 2017; 66:231–239. doi:10.1097/NNR.0000000000000219
  • Referans34 Aghaei A, Khayyamnekouei Z, Yousefy A. General health prediction based on life orientation, quality of life, life satisfaction and age. Procedia-Social and Behavioral Sciences 2013; 84:569-573. doi:10.1016/j.sbspro.2013.06.605
  • Referans35 Kabalcıoğlu Bucak F, Toker E, Asoğlu M. Women who apply therapeutic abortus’ state and trait anxiety levels and related factors.Journal of Health Academics 2018; 5: 256-263. doi:10.5455/sad.13-1543399784
  • Referans36 Mukkavaara I, Öhrling K, Lindberg I. Women’s experiences after an induced second trimester abortion.Midwifery. 2012; 28: e720-725. doi:10.1016/j.midw.2011.07.011
There are 36 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Neslihan Sayın 0000-0002-2966-0972

Şükran Ertekin Pınar 0000-0002-5431-8159

Project Number Yok
Publication Date November 30, 2022
Acceptance Date September 29, 2022
Published in Issue Year 2022

Cite

AMA Sayın N, Ertekin Pınar Ş. Posttraumatic Stress Disorder Symptoms and Related Factors in Women with Early Pregnancy Loss. J Contemp Med. November 2022;12(6):884-890. doi:10.16899/jcm.1165862