title: Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study.
abstract: OBJECTIVE
  (1) To investigate the experiences of women with a previous stillbirth and their appraisal of the care they received at the hospital. (2) To assess the long-term level of post-traumatic stress symptoms (PTSS) in this group and identify risk factors for this outcome.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  Two university hospitals.
  
  
  METHODS
  The study population comprised 379 women with a verified diagnosis of stillbirth (≥23 gestational weeks or birth weight ≥500 g) in a singleton or twin pregnancy 5-18 years previously. 101 women completed a comprehensive questionnaire in two parts.
  
  
  METHODS
  The women's experiences and appraisal of the care provided by healthcare professionals before, during and after stillbirth. PTSS at follow-up was assessed using the Impact of Event Scale (IES).
  
  
  RESULTS
  The great majority saw (98%) and held (82%) their baby. Most women felt that healthcare professionals were supportive during the delivery (85.6%) and showed respect towards their baby (94.9%). The majority (91.1%) had received some form of short-term follow-up. One-third showed clinically significant long-term PTSS (IES ≥ 20). Independent risk factors were younger age (OR 6.60, 95% CI 1.99 to 21.83), induced abortion prior to stillbirth (OR 5.78, 95% CI 1.56 to 21.38) and higher parity (OR 3.46, 95% CI 1.19 to 10.07) at the time of stillbirth. Having held the baby (OR 0.17, 95% CI 0.05 to 0.56) was associated with less PTSS.
  
  
  CONCLUSIONS
  The great majority saw and held their baby and were satisfied with the support from healthcare professionals. One in three women presented with a clinically significant level of PTSS 5-18 years after stillbirth. Having held the baby was protective, whereas prior induced abortion was a risk factor for a high level of PTSS.
  
  
  BACKGROUND
  The study was registered at http://www.clinicaltrials.gov, with registration number NCT 00856076.
authors.affiliation: Department of Haematology, Oslo University Hospital, Oslo, Norway.
authors.forename: Ida Kathrine
authors.initials: IK
authors.lastname: Gravensteen
authors.forename: Linda Björk
authors.initials: LB
authors.lastname: Helgadóttir
authors.forename: Eva-Marie
authors.initials: EM
authors.lastname: Jacobsen
authors.forename: Ingela
authors.initials: I
authors.lastname: Rådestad
authors.forename: Per Morten
authors.initials: PM
authors.lastname: Sandset
authors.forename: Oivind
authors.initials: O
authors.lastname: Ekeberg
keywords: Epidemiology