title: OS107. Pregnancies involving hypertensive disorders of pregnancy are associated with posttraumatic stress disorder.
abstract: BACKGROUND
  Pregnancies complicated by hypertensive disorders of pregnancy (HDP) can result in adverse perinatal outcomes leading to additional and unexpected levels of stress for the families involved.
  
  
  OBJECTIVE
  Our primary aim was to examine if HDP is associated with posttraumatic stress disorder (PTSD).
  
  
  METHODS
  We analyzed data collected through an online survey by the Preeclampsia Foundation on PTSD symptoms using the Breslau Short Screening Scale for DSM-IV. We compared participant characteristics between women with and without PTSD using chi-square tests for discrete variables and t-tests for continuous variables. Univariate and multivariable logistic regression analyses were used to examine the outcome of PTSD and identify possible risk factors associated with HDP.
  
  
  RESULTS
  We surveyed 1448 women (1076 HDP, 372 controls). After adjusting for psychiatric illness or mood disorder, parity, and age at affected pregnancy, we found that women with HDP were more than four times as likely to screen positive for PTSD (OR = 4.64, 95% CI: 3.37-6.39) when compared to women without HDP. Additionally, we found that PTSD symptoms increase with severity of HDP. When stratifying by severity, we found that women with gestational hypertension and preeclampsia were three and a half times more likely (OR=3.45, 95% CI: 1.70-7.00 and OR=3.48, 95% CI: 2.45-4.96, respectively); women with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome were nearly six times as likely (OR=5.76, 95% CI: 3.97-8.36), and women with eclampsia were almost ten times as likely to screen positive for PTSD (OR=9.76, 95% CI: 5.45-17.49) when compared to women without HDP.
  
  
  CONCLUSIONS
  Pregnancies complicated by HDP are associated with increased risk of PTSD, with risk of PTSD increasing as severity of HDP increases. Medical practitioners should be aware of this association and consider screening women with HDP for signs of PTSD at their first postpartum visit. Those who screen positive could then be referred for a confirmatory diagnosis and, if needed, subsequent supportive care.
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States.
authors.forename: J
authors.initials: J
authors.lastname: Porcel
authors.affiliation: Preeclampsia Foundation, Melbourne, FL, United States.
authors.forename: E
authors.initials: E
authors.lastname: Tsigas
authors.affiliation: Preeclampsia Foundation, Melbourne, FL, United States.
authors.forename: L
authors.initials: L
authors.lastname: Poye
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States.
authors.forename: M L
authors.initials: ML
authors.lastname: Wilson