title: Psychiatric disorders following fetal death: a population-based cohort study.
abstract: OBJECTIVE
  Women have increased risks of severe mental disorders after childbirth and death of a child, but it remains unclear whether this association also applies to fetal loss and, if so, to which extent. We studied the risk of any inpatient or outpatient psychiatric treatment during the time period from 12 months before to 12 months after fetal death.
  
  
  METHODS
  Cohort study using Danish population-based registers.
  
  
  METHODS
  Denmark.
  
  
  METHODS
  A total of 1 112 831 women born in Denmark from 1960 to 1995 were included. In total, 87 687cases of fetal death (International Classification of Disease-10 codes for spontaneous abortion or stillbirth) were recorded between 1996 and 2010.
  
  
  METHODS
  The main outcome measures were incidence rate ratios (risk of first psychiatric inpatient or outpatient treatment).
  
  
  RESULTS
  A total of 1379 women had at least one psychiatric episode during follow-up from the year before fetal death to the year after. Within the first few months after the loss, women had an increased risk of psychiatric contact, IRR: 1.51 (95% CI 1.15 to 1.99). In comparison, no increased risk of psychiatric contact was found for the period before fetal death. The risk of experiencing a psychiatric episode was highest for women with a loss occurring after 20 weeks of gestation (12 month probability: 1.95%, 95% CI 1.50 to 2.39).
  
  
  CONCLUSIONS
  Fetal death was associated with a transient increased risk of experiencing a first-time episode of a psychiatric disorder, primarily adjustment disorders. The risk of psychiatric episodes tended to increase with increasing gestational age at the time of the loss.
authors.affiliation: iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, National Center for Register-Based Research, Aarhus University, Aarhus V, Denmark.
authors.forename: Trine
authors.initials: T
authors.lastname: Munk-Olsen
authors.affiliation: Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Bodil Hammer
authors.initials: BH
authors.lastname: Bech
authors.affiliation: Research Unit for General Practice and Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Mogens
authors.initials: M
authors.lastname: Vestergaard
authors.affiliation: Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Jiong
authors.initials: J
authors.lastname: Li
authors.affiliation: Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark.
authors.forename: Jørn
authors.initials: J
authors.lastname: Olsen
authors.affiliation: iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, National Center for Register-Based Research, Aarhus University, Aarhus V, Denmark.
authors.forename: Thomas Munk
authors.initials: TM
authors.lastname: Laursen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology*; D018570:Risk Assessment
keywords: Epidemiology; Obstetrics; Psychiatry