title: Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample.
abstract: BACKGROUND
  Perinatal loss is often a traumatic outcome for families. While there are limited data about depressive outcomes in small populations, information about depression and posttraumatic stress disorder among large racially and economically diverse populations is sparse.
  
  
  METHODS
  We collaborated with the Michigan Department of Community Health to conduct a longitudinal survey of bereaved mothers with stillbirth or infant death under 28 days of life and live-birth (control) mothers in Michigan. The study assessed 9-month mental health outcomes including self-reported symptoms of depression and posttraumatic stress disorder along with information about demographics, pregnancy and loss experience, social support, and past and present mental health and treatment.
  
  
  RESULTS
  Of 1400 women contacted by the State of Michigan, 609 completed surveys and were eligible to participate for a 44% response rate (377 bereaved mothers and 232 control mothers with live births). In multivariable analysis, bereaved women had nearly 4-fold higher odds of having a positive screen for depression and 7-fold higher odds of a positive screen for post-traumatic stress disorder after controlling for demographic and personal risk variables. A minority of screen-positive women were receiving any type of psychiatric treatment.
  
  
  CONCLUSIONS
  This is the largest epidemiologically based study to date to measure the psychological impact of perinatal loss. Nine months after a loss, bereaved women showed high levels of distress with limited rates of treatment. Symptoms need to be monitored over time for persisting disorder and further research should identify women at highest risk for poor outcomes.
authors.affiliation: 1 Department of Family Medicine, University of Michigan , Ann Arbor, Michigan.|2 Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Gold
authors.affiliation: 2 Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan.
authors.forename: Irving
authors.initials: I
authors.lastname: Leon
authors.affiliation: 1 Department of Family Medicine, University of Michigan , Ann Arbor, Michigan.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Boggs
authors.affiliation: 1 Department of Family Medicine, University of Michigan , Ann Arbor, Michigan.|3 Department of Biostatistics, University of Michigan , Ann Arbor, Michigan.
authors.forename: Ananda
authors.initials: A
authors.lastname: Sen
mesh_terms: D000328:Adult; D001601:Bereavement; D016022:Case-Control Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D066088:Infant Death; D008137:Longitudinal Studies; D008824:Michigan / Q000453:epidemiology; D009035:Mothers / Q000523:psychology*; D015999:Multivariate Analysis; D011159:Population Surveillance; D011247:Pregnancy; D012944:Social Support; D012959:Socioeconomic Factors; D050497:Stillbirth; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult