Katherine J Gold1, Martha E Boggs2, Maria Muzik3, Ananda Sen4. 1. Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213; Department of Obstetrics and Gynecology, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213. Electronic address: ktgold@umich.edu. 2. Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA. Electronic address: haabme@umich.edu. 3. Women and Infants Mental Health Clinic, Department of Psychiatry, University of Michigan. Electronic address: muzik@umich.edu. 4. Department of Family Medicine and Department of Biostatistics University of Michigan. Electronic address: anandas@umich.edu.
Abstract
OBJECTIVE: Perinatal loss (stillbirth after 20 weeks of gestational age or infant death in the first month) impacts one to two infants per hundred live births in the United States and can be a devastating experience for parents. We assessed prevalence of anxiety disorders and obsessive compulsive disorder (OCD) among bereaved and live-birth mothers. METHODS: We collaborated with the Michigan Department of Community Health to survey Michigan mothers with perinatal death or live birth. We measured symptoms of generalized anxiety disorder, social phobia, panic disorder and OCD using validated written self-report screens and collected data on maternal demographics, psychiatric history, social support and intimate partner violence. RESULTS: A total 609/1400 mothers (44%) participated, returning surveys 9 months postdelivery. Two hundred thirty-two mothers had live birth, and 377 had perinatal loss. In unadjusted analyses, bereaved mothers had higher odds of all four disorders. In logistic regression adjusted for covariates, bereaved mothers still had higher odds of moderate-severe generalized anxiety disorder [odds ratio (OR): 2.39, confidence interval (CI): 1.10-5.18, P = .028] and social phobia (OR: 2.32, CI: 1.52-3.54, P < .0005) but not panic disorder or OCD. CONCLUSION: Bereaved mothers struggle with clinically significant anxiety disorders in the first year after perinatal loss; improved identification and treatment are essential to improve mental health for this vulnerable population.
OBJECTIVE: Perinatal loss (stillbirth after 20 weeks of gestational age or infantdeath in the first month) impacts one to two infants per hundred live births in the United States and can be a devastating experience for parents. We assessed prevalence of anxiety disorders and obsessive compulsive disorder (OCD) among bereaved and live-birth mothers. METHODS: We collaborated with the Michigan Department of Community Health to survey Michigan mothers with perinatal death or live birth. We measured symptoms of generalized anxiety disorder, social phobia, panic disorder and OCD using validated written self-report screens and collected data on maternal demographics, psychiatric history, social support and intimate partner violence. RESULTS: A total 609/1400 mothers (44%) participated, returning surveys 9 months postdelivery. Two hundred thirty-two mothers had live birth, and 377 had perinatal loss. In unadjusted analyses, bereaved mothers had higher odds of all four disorders. In logistic regression adjusted for covariates, bereaved mothers still had higher odds of moderate-severe generalized anxiety disorder [odds ratio (OR): 2.39, confidence interval (CI): 1.10-5.18, P = .028] and social phobia (OR: 2.32, CI: 1.52-3.54, P < .0005) but not panic disorder or OCD. CONCLUSION: Bereaved mothers struggle with clinically significant anxiety disorders in the first year after perinatal loss; improved identification and treatment are essential to improve mental health for this vulnerable population.
Authors: Kurt Kroenke; Tara W Strine; Robert L Spitzer; Janet B W Williams; Joyce T Berry; Ali H Mokdad Journal: J Affect Disord Date: 2008-08-27 Impact factor: 4.839
Authors: S King-Hele; R T Webb; P B Mortensen; L Appleby; A Pickles; K M Abel Journal: Arch Dis Child Fetal Neonatal Ed Date: 2008-11-10 Impact factor: 5.747