Postpartum Haemorrhage Is Associated with an Increased Risk of Postnatal Depression

Takeaway

Postpartum haemorrhage (PPH) was associated with an increase in the risk of developing postnatal depression (PND) and post-traumatic stress disorder (PTSD) in the year following delivery.

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.

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

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Sarfaroj Khan. Postpartum Haemorrhage Is Associated with an Increased Risk of Postnatal Depression - Medscape - Apr 01, 2021.

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