EPP282 - Postpartum Hemorrhage and Post-Traumatic Stress Disorder : The Role of Trait Anxiety

EPP282

Postpartum Hemorrhage and Post-Traumatic Stress Disorder : The Role of Trait Anxiety

N. Smaoui ¹, A. Jedidi ^1,*, N. Charfi ¹, M. Maalej ¹, H. Hkim ², R. Feki ¹, I. Gassara ¹, M. Maalej ¹, S. Omri ¹, L. Zouari ¹

¹Psychiatry C, ²Gynecology-Obstetrics Department, Hedi Chaker Hospital, Sfax, Tunisia

 

Introduction: Severe postpartum hemorrhage (PPH) is not only a life-threatening obstetric complication but also a potential psychological trauma. While the link between PPH and post-traumatic stress disorder (PTSD) is increasingly recognized, the role of individual vulnerability factors such as trait anxiety remains less well explored.

Objectives: The objectives of this study were to evaluate post-traumatic stress disorder (PTSD) and trait anxiety in women who experienced severe postpartum hemorrhage (PPH), and to determine the relationship between them.

Methods: A cross-sectional, descriptive, and analytical study was conducted between January and December 2024 among 49 participants who presented with severe PPH. These women had delivered between 2017 and 2023 at the Gynecology-Obstetrics Department of Hedi Chaker University Hospital in Sfax.
PTSD was assessed using the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5), with a diagnostic threshold set at a total score ≥ 31. Trait anxiety was assessed using the Spielberger Trait Anxiety Inventory (STAI-Y).
Statistical analysis was performed using SPSS-26 software.

Results: The mean age of participants at the time of delivery complicated by PPH was 31.16 ± 5.86 years (min = 19, max = 47), and 34.16 ± 6.03 years (min = 23, max = 49) at the time of the interview.
The mean STAI-Y score was 49.39 ± 11.395 (min = 32, max = 72). Trait anxiety was present in 51% of participants.
The mean PCL-5 score was 31.81 ± 18.54 (min = 4, max = 71), with a PTSD prevalence of 44.9% (n=22).
Mean scores for the PCL-5 dimensions were 7.98 ± 5.59 for re-experiencing (min = 0, max = 18), 3.78 ± 2.53 for avoidance (min = 0, max = 8), 9.84 ± 8.53 for negative alterations in cognition and mood (min = 0, max = 28), and 9.61 ± 4.83 for hyperarousal (min = 0, max = 22).
A significant correlation was observed between the PCL-5 and STAI-Y scores, with a Pearson coefficient r = 0.564 (p < 0.01), indicating a positive association between PTSD and trait anxiety. In multivariate analysis, trait anxiety (STAI-Y) (OR = 5.14; 95% CI 1.52–17.38; p = 0.008) remained a significant independent predictor of PTSD.

Conclusions: Severe PPH is a highly traumatic event. Chronic anxiety appears to be an important risk factor for PTSD, underscoring the need for targeted preventive and therapeutic strategies.

 

Disclosure of Interest: None Declared