Category: Medical/Surgical/Diseases/Complications
Poster Session I
Both preterm birth and stillbirth can contribute to postpartum psychological distress. Anger is a common reaction after stillbirth, but rates of postpartum anger have not been studied between stillbirths, preterm births and term births. The objective of this study is to quantitatively evaluate the differences in postpartum anger after stillbirth, preterm live birth, and term live birth in a national cohort.
Study Design:
This is a secondary analysis of prospective case-control study from the Stillbirth Collaborative Research Network (SCRN). Longitudinal pregnancy, delivery and postpartum data were collected between people who had stillbirths and live births (preterm birth [PTB] and term birth) across five regions (RI, MA, TX, GA, UT) from 2006-2009. As a measure of anger, State Trait Anger Expression Inventory (STAXI-2) scores were compared between those who experienced stillbirth, live PTB and live term birth. Multivariate logistic regression was performed. We also performed a stratified analysis among stillbirths and live PTB according to gestational age (GA) range ( < 28 weeks, 28-33’6 weeks, 34-36’6 weeks).
Results:
These analyses included 545 stillbirths, 388 live PTB and 1315 live term births. There were significant demographic and pregnancy characteristic differences between groups (Table 1). Anger scores were significantly higher in both stillbirths and live PTB compared to term live births (confirmed by regression); there was no difference when stillbirths were compared to PTB. In the analysis stratified by GA, anger scores did not differ between those with stillbirth and those with live PTB < 34 weeks, but were lower among those who delivered after 34 weeks compared to stillbirths.
Conclusion:
Postpartum anger is significantly higher in stillbirths and live PTB compared to term live births but does not significantly differ between stillbirths and early PTB. Interventions intended to reduce anger may facilitate bereavement and improved mental health in parturients experiencing adverse pregnancy outcomes.
Tess E.K Cersonsky, BS (she/her/hers)
Medical Student
Alpert Medical School of Brown University
Providence, Rhode Island, United States
Adam K. Lewkowitz, MD, MPHS
Assistant Professor
Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island
Providence, Rhode Island, United States
Halit Pinar, MD
Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island
Providence, Rhode Island, United States
George R. Saade, MD
Professor & Chief of Obstetrics & Maternal-Fetal Medicine
University of Texas Medical Branch
Galveston, Texas, United States
Donald J. Dudley, MD
University of Virginia
Charlottesville, Virginia, United States
Robert M. Silver, MD
University of Utah Health
Salt Lake City, Utah, United States
Nina K. Ayala, MD
Attending Physician
Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States