Association of Prenatal Stressful Life Events with Depression and Post-Traumatic Stress 6-36 Months After Stillbirth 公开
Brister, Sarah (Spring 2018)
Abstract
Stillbirth, death of a fetus after 20 weeks gestation, is an emotionally devastating pregnancy outcome and occurs at a rate of 5.96 per 1,000 livebirths in the United States. This traumatic event may have a lasting impact on the mental health of women who experience it. Although research provides evidence that stressful life events may increase post-traumatic stress symptoms after a traumatic event, no analysis has examined the association of pre-pregnancy stressful life events and post-traumatic stress symptoms after experiencing a stillbirth. To investigate this question, data from 238 women who had experienced a singleton stillbirth enrolled in the Stillbirth Collaborative Research Network (SCRN), a population-based case-control study, and follow up in the SCRN-Outcomes after Study Index Stillbirth (OASIS) were used. Post-traumatic stress was measured by the Impact of Events Scale-15 item version, current depression by the Edinburgh Depression Scale, and stressful life events by the PRAMS 13-item list. Post-traumatic stress symptoms were strongly associated with current depression (Adjusted Odds Ratio (aOR) [95% Confidence Interval (CI)]: 10.55 [3.93, 28.37]). When adjusted for insurance status, marital status, and experiencing a mental health condition before the pregnancy, the relationship between Stressful Life Events and Impact of Events Score was not significant among women with current depression (aOR [95% CI]: 1.02 [0.13, 7.79]) and was not able to be calculated among women without current depression. Mediation analyses were performed to examine stressful life events as a potential mediator, and no results were significant. Consistent with past research, this study found that depression is strongly related to post-traumatic stress symptoms. No significant relationship between stressful life events and post-traumatic stress among women who experienced a stillbirth existed in this data. Due to stratification on stillbirth status and presence of current depression, sample sizes were small and further study can investigate the impact of stressful life events as an exposure for mental health outcomes in a larger sample.
Table of Contents
Chapter I: Background and Literature Review ……………………………………… 1
Chapter II: Manuscript ………………………………………………………………. 8
Introduction …………………………………………………………………. 9
Methods ……..………………………………………………………………. 13
Results …………………………………………………………….……...…. 16
Discussion ……………………………………………………………......…. 21
References …………………………………………………………………… 24
Tables/Figures ………………………………………………………………. 27
Chapter III: Public Health Implications …..……………………………….….….…. 38
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Association of Prenatal Stressful Life Events with Depression and Post-Traumatic Stress 6-36 Months After Stillbirth () | 2018-04-24 12:36:51 -0400 |
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