Long-term psychosocial sequelae of stillbirth: phase II of a nested case-control cohort study
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Stillbirth is associated with increased psychological morbidity in the subsequent pregnancy and puerperium. This study aimed to assess longer-term psychological and social outcomes of stillbirth and to identify factors associated with adverse outcome. We conducted seven-year follow-up of a cohort of women who were initially assessed during and after a pregnancy subsequent to stillbirth, together with pair-matched controls. All women were living with a partner at baseline and none had live children. Measured outcomes at follow-up included depression, posttraumatic stress disorder (PTSD) and partnership breakdown. Comparison variables included social and psychological factors and, for the stillbirth group, factors relating to the lost pregnancy. There were no differences between groups in case level psychological morbidity, but significantly higher levels of PTSD symptoms persisted in stillbirth group mothers who had case level PTSD 7 years earlier. Stillbirth group mothers were more likely to have experienced subsequent partnership breakdown. In the stillbirth group such breakdown was associated with having held the stillborn infant and having had case-level PTSD. Interpretations and clinical implications of these findings are discussed.
KeywordsStillbirth Psychosocial outcomes PTSD Partnership breakdown
The authors gratefully acknowledge the financial support of the Sir Sigismund Warburg Voluntary Settlement Fund in carrying out this study. The study sponsors had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. Special thanks are due to the families who participated in the study. The contributions of Julia Ward and Samantha Riches in data collection are also gratefully acknowledged.
Details of contributors
Penelope Turton wrote the paper and was involved in design of the study, data collection and analysis. Chris Evans was responsible for data analysis and contributed to drafts of the paper. Patricia Hughes was responsible for the conception and design of the study, and contributed to drafts of the paper. All authors have approved the final version of the paper.
Declaration of interest
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