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Women who experience stillbirth or infant death have extraordinarily high rates of depression and anxiety, which are inadequately addressed, according to findings from the Michigan Mother’s Study.
The effects were particularly pronounced among African American women, according to Dr. Katherine J. Gold who will present the findings of her award-winning abstract on Wednesday at the annual meeting of the American Congress of Obstetricians and Gynecologists.
At 9 months after delivery, the rates of positive screens for a number of mental health issues were dramatically and statistically significantly higher in 377 bereaved women who experienced stillbirth or infant death in the first month, compared with 232 control mothers with live birth who participated in the 2-year longitudinal population-based cohort study. The rates were 23% vs. 8% for depression, 41% vs. 12% for posttraumatic stress disorder, 19% vs. 7% for general anxiety disorder, 19% vs. 6% for social phobia, and 12% vs. 6% for panic disorder for the groups, respectively, said Dr. Gold of the University of Michigan, Ann Arbor.
"These high rates of symptoms were significant even when controlling for demographic factors, prior mental health problems, social support, and interpersonal violence," Dr. Gold said in an interview.
Also, the rates of these mental health issues were similar among mothers who experienced stillbirth and those who experienced infant death, suggesting that both losses can be powerful and traumatic experiences.
Although bereaved African American women had similar levels of distress as other bereaved women, they were significantly less likely to have received treatment, Dr. Gold noted.
This study is the first population-based study to look at mental health outcomes among women who experience perinatal death.
"The findings suggest that bereaved mothers have dramatically higher levels of persistent distress, which may be underrecognized by health care providers. It is important for physicians and midwives to assess for mental health symptoms after a loss," she said adding that because it has been shown that depression during a subsequent pregnancy poses substantial risk to fetal and infant outcomes, identifying and treating depression in women before and during subsequent pregnancy is critical for improving outcomes.
Dr. Gold reported having no disclosures.
The findings by Dr. Gold and her colleagues highlight the need to enhance efforts to identify women with mental health sequelae after the loss of an infant, according to Dr. C. Neill Epperson.
"As a reproductive psychiatrist for over 20 years, the main findings of this study ring true in my clinical experience. The loss of a child at birth or during infancy can be as traumatic as the loss of an older child," she said.
While the results of the study are from mailed surveys and not clinical interviews, the degree of self-reported distress is considerable, and the fact that African American women were in greater distress and less likely to be receiving treatment is quite disturbing.
Dr. Epperson is director of the Penn Center for Women’s Behavioral Wellness and is in the departments of psychiatry and obstetrics and gynecology at the University of Pennsylvania, Philadelphia. She reported having no disclosures.
The findings by Dr. Gold and her colleagues highlight the need to enhance efforts to identify women with mental health sequelae after the loss of an infant, according to Dr. C. Neill Epperson.
"As a reproductive psychiatrist for over 20 years, the main findings of this study ring true in my clinical experience. The loss of a child at birth or during infancy can be as traumatic as the loss of an older child," she said.
While the results of the study are from mailed surveys and not clinical interviews, the degree of self-reported distress is considerable, and the fact that African American women were in greater distress and less likely to be receiving treatment is quite disturbing.
Dr. Epperson is director of the Penn Center for Women’s Behavioral Wellness and is in the departments of psychiatry and obstetrics and gynecology at the University of Pennsylvania, Philadelphia. She reported having no disclosures.
The findings by Dr. Gold and her colleagues highlight the need to enhance efforts to identify women with mental health sequelae after the loss of an infant, according to Dr. C. Neill Epperson.
"As a reproductive psychiatrist for over 20 years, the main findings of this study ring true in my clinical experience. The loss of a child at birth or during infancy can be as traumatic as the loss of an older child," she said.
While the results of the study are from mailed surveys and not clinical interviews, the degree of self-reported distress is considerable, and the fact that African American women were in greater distress and less likely to be receiving treatment is quite disturbing.
Dr. Epperson is director of the Penn Center for Women’s Behavioral Wellness and is in the departments of psychiatry and obstetrics and gynecology at the University of Pennsylvania, Philadelphia. She reported having no disclosures.
Women who experience stillbirth or infant death have extraordinarily high rates of depression and anxiety, which are inadequately addressed, according to findings from the Michigan Mother’s Study.
The effects were particularly pronounced among African American women, according to Dr. Katherine J. Gold who will present the findings of her award-winning abstract on Wednesday at the annual meeting of the American Congress of Obstetricians and Gynecologists.
At 9 months after delivery, the rates of positive screens for a number of mental health issues were dramatically and statistically significantly higher in 377 bereaved women who experienced stillbirth or infant death in the first month, compared with 232 control mothers with live birth who participated in the 2-year longitudinal population-based cohort study. The rates were 23% vs. 8% for depression, 41% vs. 12% for posttraumatic stress disorder, 19% vs. 7% for general anxiety disorder, 19% vs. 6% for social phobia, and 12% vs. 6% for panic disorder for the groups, respectively, said Dr. Gold of the University of Michigan, Ann Arbor.
"These high rates of symptoms were significant even when controlling for demographic factors, prior mental health problems, social support, and interpersonal violence," Dr. Gold said in an interview.
Also, the rates of these mental health issues were similar among mothers who experienced stillbirth and those who experienced infant death, suggesting that both losses can be powerful and traumatic experiences.
Although bereaved African American women had similar levels of distress as other bereaved women, they were significantly less likely to have received treatment, Dr. Gold noted.
This study is the first population-based study to look at mental health outcomes among women who experience perinatal death.
"The findings suggest that bereaved mothers have dramatically higher levels of persistent distress, which may be underrecognized by health care providers. It is important for physicians and midwives to assess for mental health symptoms after a loss," she said adding that because it has been shown that depression during a subsequent pregnancy poses substantial risk to fetal and infant outcomes, identifying and treating depression in women before and during subsequent pregnancy is critical for improving outcomes.
Dr. Gold reported having no disclosures.
Women who experience stillbirth or infant death have extraordinarily high rates of depression and anxiety, which are inadequately addressed, according to findings from the Michigan Mother’s Study.
The effects were particularly pronounced among African American women, according to Dr. Katherine J. Gold who will present the findings of her award-winning abstract on Wednesday at the annual meeting of the American Congress of Obstetricians and Gynecologists.
At 9 months after delivery, the rates of positive screens for a number of mental health issues were dramatically and statistically significantly higher in 377 bereaved women who experienced stillbirth or infant death in the first month, compared with 232 control mothers with live birth who participated in the 2-year longitudinal population-based cohort study. The rates were 23% vs. 8% for depression, 41% vs. 12% for posttraumatic stress disorder, 19% vs. 7% for general anxiety disorder, 19% vs. 6% for social phobia, and 12% vs. 6% for panic disorder for the groups, respectively, said Dr. Gold of the University of Michigan, Ann Arbor.
"These high rates of symptoms were significant even when controlling for demographic factors, prior mental health problems, social support, and interpersonal violence," Dr. Gold said in an interview.
Also, the rates of these mental health issues were similar among mothers who experienced stillbirth and those who experienced infant death, suggesting that both losses can be powerful and traumatic experiences.
Although bereaved African American women had similar levels of distress as other bereaved women, they were significantly less likely to have received treatment, Dr. Gold noted.
This study is the first population-based study to look at mental health outcomes among women who experience perinatal death.
"The findings suggest that bereaved mothers have dramatically higher levels of persistent distress, which may be underrecognized by health care providers. It is important for physicians and midwives to assess for mental health symptoms after a loss," she said adding that because it has been shown that depression during a subsequent pregnancy poses substantial risk to fetal and infant outcomes, identifying and treating depression in women before and during subsequent pregnancy is critical for improving outcomes.
Dr. Gold reported having no disclosures.
FROM THE ACOG ANNUAL CLINICAL MEETING
Major finding: Bereaved mothers had significantly more depression (23% vs. 8%), PTSD (41% vs. 12%), general anxiety disorder (19% vs. 7%), social phobia (19% vs. 6%), and panic disorder (12% vs. 6%) than did 232 control mothers who experienced live birth.
Data source: A longitudinal, population-based cohort study involving 609 women (the Michigan Mother’s Study).
Disclosures: Dr. Gold reported having no disclosures.