TY - JOUR
T1 - Association of severe postpartum hemorrhage and development of psychological disorders
T2 - Results from the prospective and multicentre HELP MOM study
AU - Deniau, Benjamin
AU - Ricbourg, Aude
AU - Weiss, Emmanuel
AU - Paugam-Burtz, Catherine
AU - Bonnet, Marie Pierre
AU - Goffinet, François
AU - Mignon, Alexandre
AU - Morel, Olivier
AU - Le Guen, Morgan
AU - Binczak, Marie
AU - Carbonnel, Marie
AU - Michelet, Daphné
AU - Dahmani, Souhayl
AU - Pili-Floury, Sébastien
AU - Ducloy Bouthors, Anne Sophie
AU - Mebazaa, Alexandre
AU - Gayat, Etienne
N1 - Publisher Copyright:
© 2023
PY - 2024/4/1
Y1 - 2024/4/1
N2 - Objective: Post-partum hemorrhage (PPH) is the leading preventable cause of worldwide maternal morbidity and mortality. Risk factors for psychological disorders following PPH are currently unknown. HELP-MOM study aimed to determine the incidence and identify risk factors for psychological disorders following PPH. Methods: HELP-MOM study was a prospective, observational, national, and multicentre study including patients who experienced severe PPH requiring sulprostone. The primary endpoint was the occurrence of psychological disorders (anxiety and/or post-traumatic disorder and/or depression) following PPH, assessed at 1, 3, and 6 months after delivery using HADS, IES-R, and EPDS scales. Results: Between November 2014 and November 2016, 332 patients experienced a severe PPH and 236 (72%) answered self-questionnaires at 1, 3, and 6 months. A total of 161 (68%) patients declared a psychological disorder following severe PPH (146 (90.1%) were screened positive for anxiety, 96 (58.9%) were screened positive for post-traumatic stress disorder, and 94 (57.7%) were screened positive for post-partum depression). In multivariable analysis, the use of intra-uterine tamponnement balloon was associated with a lower risk to be screened positive for psychological disorder after severe PPH (OR = 0.33 [IC95% 0.15−0.69], p = 0.004, and after propensity score matching (OR=0.34 [IC95% 0.12−0.94], p = 0.04)). Low hemoglobin values during severe PPH management were associated with a higher risk of being screened positive for psychological disorders. Finally, we did not find differences in desire or pregnancy between patients without or with psychological disorders occurring in the year after severe PPH. Discussion: Severe PPH was associated with significant psychosocial morbidity including anxiety, post-traumatic disorder, and depression. This should engage a psychological follow-up. Large cohorts are urgently needed to confirm our results. Registration: ClinicalTrials.gov under number NCT02118038.
AB - Objective: Post-partum hemorrhage (PPH) is the leading preventable cause of worldwide maternal morbidity and mortality. Risk factors for psychological disorders following PPH are currently unknown. HELP-MOM study aimed to determine the incidence and identify risk factors for psychological disorders following PPH. Methods: HELP-MOM study was a prospective, observational, national, and multicentre study including patients who experienced severe PPH requiring sulprostone. The primary endpoint was the occurrence of psychological disorders (anxiety and/or post-traumatic disorder and/or depression) following PPH, assessed at 1, 3, and 6 months after delivery using HADS, IES-R, and EPDS scales. Results: Between November 2014 and November 2016, 332 patients experienced a severe PPH and 236 (72%) answered self-questionnaires at 1, 3, and 6 months. A total of 161 (68%) patients declared a psychological disorder following severe PPH (146 (90.1%) were screened positive for anxiety, 96 (58.9%) were screened positive for post-traumatic stress disorder, and 94 (57.7%) were screened positive for post-partum depression). In multivariable analysis, the use of intra-uterine tamponnement balloon was associated with a lower risk to be screened positive for psychological disorder after severe PPH (OR = 0.33 [IC95% 0.15−0.69], p = 0.004, and after propensity score matching (OR=0.34 [IC95% 0.12−0.94], p = 0.04)). Low hemoglobin values during severe PPH management were associated with a higher risk of being screened positive for psychological disorders. Finally, we did not find differences in desire or pregnancy between patients without or with psychological disorders occurring in the year after severe PPH. Discussion: Severe PPH was associated with significant psychosocial morbidity including anxiety, post-traumatic disorder, and depression. This should engage a psychological follow-up. Large cohorts are urgently needed to confirm our results. Registration: ClinicalTrials.gov under number NCT02118038.
KW - Anxiety
KW - Depression
KW - Post-traumatic stress disorder
KW - Postpartum hemorrhage
KW - Psychological disorder
UR - http://www.scopus.com/inward/record.url?scp=85182641442&partnerID=8YFLogxK
U2 - 10.1016/j.accpm.2023.101340
DO - 10.1016/j.accpm.2023.101340
M3 - Article
C2 - 38128731
AN - SCOPUS:85182641442
SN - 2352-5568
VL - 43
JO - Anaesthesia Critical Care and Pain Medicine
JF - Anaesthesia Critical Care and Pain Medicine
IS - 2
M1 - 101340
ER -