Miscarriage and ectopic pregnancy may trigger post-traumatic stress – study

By Nina Massey, PA Science Correspondent

Around 18% of women experience post-traumatic stress after a miscarriage or ectopic pregnancy, new research suggests.

The study looked at the psychological impact of early-stage pregnancy loss.

Researchers looked at 653 women who had experienced early pregnancy loss.

They majority had suffered an early miscarriage – defined as a pregnancy loss before 12 weeks, or an ectopic pregnancy.

Published in the journal American Journal of Obstetrics and Gynaecology, the study found that one month after pregnancy loss 29% suffered post-traumatic stress.

Almost a quarter (24%) experienced moderate to severe anxiety, and one in nine (11%) had moderate to severe depression.

After nine months, 18% of women had post-traumatic stress, 17% had moderate to severe anxiety, and 6% had moderate to severe depression.

Scientists at Imperial College London and KU Leuven in Belgium say it is the largest ever study to look at the psychological impact.

Professor Tom Bourne, lead author of the research from Tommy’s National Centre for Miscarriage Research at Imperial College London, said: “Pregnancy loss affects up to one in two women, and for many women it will be the most traumatic event in their life.

“This research suggests the loss of a longed-for child can leave a lasting legacy, and result in a woman still suffering post-traumatic stress nearly a year after her pregnancy loss.”

He added: “The treatment women receive following early pregnancy loss must change to reflect its psychological impact, and recent efforts to encourage people to talk more openly about this very common issue are a step in the right direction.”

One in four pregnancies ends in miscarriage, and estimates suggest there are 250,000 miscarriages every year in the UK, and around 11,000 emergency admissions for ectopic pregnancies.

The latter always result in pregnancy loss, as an embryo grows in an area outside of the womb and is unable to develop.

The women in the study attended the Early Pregnancy Assessment Units at three London hospitals – Queen Charlotte’s and Chelsea, St Mary’s, and Chelsea and Westminster.

They were asked to complete questionnaires about their emotions and behaviour one month after pregnancy loss, then again three and nine months later.

Their responses were compared to 171 women who had healthy pregnancies.

According to the results, the psychological symptoms of women with healthy pregnancies were significantly lower than in women who had suffered early pregnancy loss.

Participants who met the criteria for post-traumatic stress reported regularly re-experiencing the feelings associated with the pregnancy loss, and suffering intrusive or unwanted thoughts about their miscarriage.

Some also reported having nightmares and flashbacks.

The authors caution the study used a questionnaire for screening, but formal diagnosis of post-traumatic stress disorder would require a clinical interview.

They add that women who were already experiencing symptoms of post-traumatic stress and depression may have been more likely to respond to the questionnaire.

This could mean the number of women suffering psychological symptoms may appear higher.

Dr Jessica Farren, first author of the research from Imperial College, and obstetrician and gynaecologist, said: “Post-traumatic stress can have a toxic effect on all elements of a person’s life – affecting work, home and relationships.”