Postpartum Haemorrhage Is Associated with an Increased Risk of Postnatal Depression

Sarfaroj Khan 

Disclosures

April 01, 2021

Takeaway

Why this matters

  • In clinical practice, vigilance in women exposed to PPH needs to be raised and assessment for PND and PTSD should form an integral part of the follow-up given the associated increased risk following PPH.

Study design

  • A retrospective open cohort study of 42,327 women from linked primary care (The Health Improvement Network) and secondary care (Hospital Episode Statistics) databases (1990-2018).

  • Of these, 14,109 women who had a PPH during index delivery were matched to 28,218 women unexposed to PPH.

  • Primary outcome: PND following PPH; secondary outcomes: PTSD, severe mental illness and anxiety.

  • Funding: None.

Key results

  • Women exposed to PPH vs those unexposed were at an increased risk of developing PND (adjusted HR [aHR], 1.10; 95% CI, 1.01-1.21; P=.037).

  • Women exposed to PPH vs those unexposed had an increased risk of PTSD (aHR, 1.17; 95% CI, 0.73-1.89; P=.511), although this was not statistically significant.

  • In the first year of follow-up after childbirth, women with PPH vs those without were at an increased risk of PTSD (aHR, 3.44; 95% CI, 1.31-9.03).

  • No significant difference was seen between women with PPH and those without in the overall risk of:

    • severe mental illness (aHR, 0.65; 95% CI, 0.40-1.08; P=.095);

    • depression (aHR, 0.94; 95% CI, 0.87-1.01; P=.103); and

    • anxiety (aHR, 0.99; 95% CI, 0.90-1.09; P=.881).

Limitations

  • Retrospective design.

 

Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. J Psychiatr Res. 2021;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. PMID: 33774536.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....