Benjamin Deniau , Aude Ricbourg , Emmanuel Weiss , Catherine Paugam-Burtz , Marie-Pierre Bonnet , François Goffinet , Alexandre Mignon , Olivier Morel , Morgan Le Guen , Marie Binczak , Marie Carbonnel , Daphné Michelet , Souhayl Dahmani , Sébastien Pili-Floury , Anne Sophie Ducloy Bouthors , Alexandre Mebazaa , Etienne Gayat
{"title":"严重产后出血与心理障碍发展的关系：前瞻性多中心 HELP MOM 研究的结果","authors":"Benjamin Deniau , Aude Ricbourg , Emmanuel Weiss , Catherine Paugam-Burtz , Marie-Pierre Bonnet , François Goffinet , Alexandre Mignon , Olivier Morel , Morgan Le Guen , Marie Binczak , Marie Carbonnel , Daphné Michelet , Souhayl Dahmani , Sébastien Pili-Floury , Anne Sophie Ducloy Bouthors , Alexandre Mebazaa , Etienne Gayat","doi":"10.1016/j.accpm.2023.101340","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Post-partum hemorrhage (PPH) is the leading preventable cause of worldwide maternal morbidity and mortality. Risk factors for psychological disorders following PPH are currently unknown. HELP-MOM study aimed to determine the incidence and identify risk factors for psychological disorders following PPH.</p></div><div><h3>Methods</h3><p><span><span>HELP-MOM study was a prospective, observational, national, and multicentre study including patients who experienced severe PPH requiring sulprostone. The primary endpoint was the occurrence of psychological disorders (anxiety and/or post-traumatic disorder and/or depression) following PPH, assessed at 1, 3, and 6 months after delivery using </span>HADS, IES-R, and </span>EPDS scales.</p></div><div><h3>Results</h3><p>Between November 2014 and November 2016, 332 patients experienced a severe PPH and 236 (72%) answered self-questionnaires at 1, 3, and 6 months. A total of 161 (68%) patients declared a psychological disorder following severe PPH (146 (90.1%) were screened positive for anxiety, 96 (58.9%) were screened positive for post-traumatic stress disorder, and 94 (57.7%) were screened positive for post-partum depression). In multivariable analysis, the use of intra-uterine tamponnement balloon was associated with a lower risk to be screened positive for psychological disorder after severe PPH (OR = 0.33 [IC95% 0.15−0.69], <em>p</em><span> = 0.004, and after propensity score matching (OR=0.34 [IC95% 0.12−0.94], </span><em>p</em> = 0.04)). Low hemoglobin values during severe PPH management were associated with a higher risk of being screened positive for psychological disorders. Finally, we did not find differences in desire or pregnancy between patients without or with psychological disorders occurring in the year after severe PPH.</p></div><div><h3>Discussion</h3><p>Severe PPH was associated with significant psychosocial morbidity including anxiety, post-traumatic disorder, and depression. This should engage a psychological follow-up. Large cohorts are urgently needed to confirm our results.</p></div><div><h3>Registration</h3><p>ClinicalTrials.gov under number <span>NCT02118038</span><svg><path></path></svg>.</p></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"43 2","pages":"Article 101340"},"PeriodicalIF":3.7000,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of severe postpartum hemorrhage and development of psychological disorders: Results from the prospective and multicentre HELP MOM study\",\"authors\":\"Benjamin Deniau , Aude Ricbourg , Emmanuel Weiss , Catherine Paugam-Burtz , Marie-Pierre Bonnet , François Goffinet , Alexandre Mignon , Olivier Morel , Morgan Le Guen , Marie Binczak , Marie Carbonnel , Daphné Michelet , Souhayl Dahmani , Sébastien Pili-Floury , Anne Sophie Ducloy Bouthors , Alexandre Mebazaa , Etienne Gayat\",\"doi\":\"10.1016/j.accpm.2023.101340\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Post-partum hemorrhage (PPH) is the leading preventable cause of worldwide maternal morbidity and mortality. Risk factors for psychological disorders following PPH are currently unknown. HELP-MOM study aimed to determine the incidence and identify risk factors for psychological disorders following PPH.</p></div><div><h3>Methods</h3><p><span><span>HELP-MOM study was a prospective, observational, national, and multicentre study including patients who experienced severe PPH requiring sulprostone. The primary endpoint was the occurrence of psychological disorders (anxiety and/or post-traumatic disorder and/or depression) following PPH, assessed at 1, 3, and 6 months after delivery using </span>HADS, IES-R, and </span>EPDS scales.</p></div><div><h3>Results</h3><p>Between November 2014 and November 2016, 332 patients experienced a severe PPH and 236 (72%) answered self-questionnaires at 1, 3, and 6 months. A total of 161 (68%) patients declared a psychological disorder following severe PPH (146 (90.1%) were screened positive for anxiety, 96 (58.9%) were screened positive for post-traumatic stress disorder, and 94 (57.7%) were screened positive for post-partum depression). In multivariable analysis, the use of intra-uterine tamponnement balloon was associated with a lower risk to be screened positive for psychological disorder after severe PPH (OR = 0.33 [IC95% 0.15−0.69], <em>p</em><span> = 0.004, and after propensity score matching (OR=0.34 [IC95% 0.12−0.94], </span><em>p</em> = 0.04)). Low hemoglobin values during severe PPH management were associated with a higher risk of being screened positive for psychological disorders. Finally, we did not find differences in desire or pregnancy between patients without or with psychological disorders occurring in the year after severe PPH.</p></div><div><h3>Discussion</h3><p>Severe PPH was associated with significant psychosocial morbidity including anxiety, post-traumatic disorder, and depression. This should engage a psychological follow-up. Large cohorts are urgently needed to confirm our results.</p></div><div><h3>Registration</h3><p>ClinicalTrials.gov under number <span>NCT02118038</span><svg><path></path></svg>.</p></div>\",\"PeriodicalId\":48762,\"journal\":{\"name\":\"Anaesthesia Critical Care & Pain Medicine\",\"volume\":\"43 2\",\"pages\":\"Article 101340\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2023-12-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anaesthesia Critical Care & Pain Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352556823001480\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia Critical Care & Pain Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352556823001480","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Association of severe postpartum hemorrhage and development of psychological disorders: Results from the prospective and multicentre HELP MOM study
Objective
Post-partum hemorrhage (PPH) is the leading preventable cause of worldwide maternal morbidity and mortality. Risk factors for psychological disorders following PPH are currently unknown. HELP-MOM study aimed to determine the incidence and identify risk factors for psychological disorders following PPH.
Methods
HELP-MOM study was a prospective, observational, national, and multicentre study including patients who experienced severe PPH requiring sulprostone. The primary endpoint was the occurrence of psychological disorders (anxiety and/or post-traumatic disorder and/or depression) following PPH, assessed at 1, 3, and 6 months after delivery using HADS, IES-R, and EPDS scales.
Results
Between November 2014 and November 2016, 332 patients experienced a severe PPH and 236 (72%) answered self-questionnaires at 1, 3, and 6 months. A total of 161 (68%) patients declared a psychological disorder following severe PPH (146 (90.1%) were screened positive for anxiety, 96 (58.9%) were screened positive for post-traumatic stress disorder, and 94 (57.7%) were screened positive for post-partum depression). In multivariable analysis, the use of intra-uterine tamponnement balloon was associated with a lower risk to be screened positive for psychological disorder after severe PPH (OR = 0.33 [IC95% 0.15−0.69], p = 0.004, and after propensity score matching (OR=0.34 [IC95% 0.12−0.94], p = 0.04)). Low hemoglobin values during severe PPH management were associated with a higher risk of being screened positive for psychological disorders. Finally, we did not find differences in desire or pregnancy between patients without or with psychological disorders occurring in the year after severe PPH.
Discussion
Severe PPH was associated with significant psychosocial morbidity including anxiety, post-traumatic disorder, and depression. This should engage a psychological follow-up. Large cohorts are urgently needed to confirm our results.
期刊介绍：
Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.
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