Postpartum Hemorrhage and Post-Traumatic Stress Disorder : The Role of Trait Anxiety
N. Smaoui, A. Jedidi, N. Charfi, M. Maalej, H. Hkim, R. Feki, I. Gassara, M. Maalej, S. Omri, L. ZouariIntroduction
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