Takeaway
- Postpartum haemorrhage (PPH) was associated with an increase in the risk of developing postnatal depression (PND) and post-traumatic stress disorder (PTSD) in the year following delivery.
Why this matters
- In clinical practice, vigilance in women exposed to PPH needs to be raised and assessment for PND and PTSD should form an integral part of the follow-up given the associated increased risk following PPH.
Study design
- A retrospective open cohort study of 42,327 women from linked primary care (The Health Improvement Network) and secondary care (Hospital Episode Statistics) databases (1990-2018).
- Of these, 14,109 women who had a PPH during index delivery were matched to 28,218 women unexposed to PPH.
- Primary outcome: PND following PPH; secondary outcomes: PTSD, severe mental illness and anxiety.
- Funding: None.
Key results
- Women exposed to PPH vs those unexposed were at an increased risk of developing PND (adjusted HR [aHR], 1.10; 95% CI, 1.01-1.21; P=.037).
- Women exposed to PPH vs those unexposed had an increased risk of PTSD (aHR, 1.17; 95% CI, 0.73-1.89; P=.511), although this was not statistically significant.
- In the first year of follow-up after childbirth, women with PPH vs those without were at an increased risk of PTSD (aHR, 3.44; 95% CI, 1.31-9.03).
- No significant difference was seen between women with PPH and those without in the overall risk of:
- severe mental illness (aHR, 0.65; 95% CI, 0.40-1.08; P=.095);
- depression (aHR, 0.94; 95% CI, 0.87-1.01; P=.103); and
- anxiety (aHR, 0.99; 95% CI, 0.90-1.09; P=.881).
Limitations
- Retrospective design.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
