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Depression, anxiety, PTSD, and OCD after stillbirth: a systematic review
Cèline Lossius Westby1, Andrea Røsberg Erlandsen1, Sondre Aasen Nilsen2,3
1Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, 5020 Bergen, Bergen, Norway.
Insights
Parents experiencing stillbirth face significantly higher risks of depression, anxiety, and post-traumatic stress disorder (PTSD). Further research is needed on predictors and diverse populations to improve postpartum care.
Area of Science:
- Perinatal Mental Health
- Psychological Trauma
- Grief and Loss
Background:
- Stillbirth impacts parental mental health, necessitating updated research on associated psychological conditions.
- Previous studies indicate potential links between stillbirth and parental depression, anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).
Purpose of the Study:
- To systematically review and summarize existing quantitative research on parental mental health outcomes following stillbirth.
- To identify the prevalence and predictors of depression, anxiety, PTSD, and OCD in parents after stillbirth (≥20 weeks gestation).
Main Methods:
- A comprehensive literature search was performed in Web of Science and PsychINFO.
- Included studies were peer-reviewed, quantitative, English-language articles published from 1980 onwards.
- Studies focused on depression, anxiety, PTSD, or OCD in parents after stillbirth defined as ≥20 weeks gestation.
Main Results:
- Thirteen quantitative studies met the inclusion criteria, investigating depression, anxiety, and PTSD; no studies on OCD were found.
- Parents experiencing stillbirth reported higher short- and long-term levels of depression, anxiety, and PTSD compared to parents with live births.
- Key predictors of symptom severity included social support, marital status, negative appraisals, and aspects of perinatal care.
Conclusions:
- Stillbirth significantly increases the risk of parental depression, anxiety, and PTSD.
- Further longitudinal research is essential to understand symptom development over time.
- Additional research is needed on fathers, transgender, non-binary, and gender-fluid individuals, as well as the link between stillbirth and OCD, to inform better postpartum care.
Background:
This systematic review aimed to provide an updated summary of studies investigating depression, anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) in parents after stillbirth (from 20 weeks gestational age until birth).
Methods:
A literature search was conducted in the databases Web of Science and PsychINFO. Main inclusion criteria were 1) peer-reviewed, quantitative, English-language articles published from 1980; (2) studies investigating depression, anxiety, PTSD, or OCD among parents following stillbirth; and (3) studies defining stillbirth as equal to or after 20 weeks of gestation.
Results:
Thirteen quantitative, peer-reviewed articles were eligible for inclusion. Selected articles investigated depression, anxiety, and PTSD, while no studies on OCD met our inclusion criteria. The majority of studies investigated women, while only two studies included men. The results indicated heightened short- and long-term levels of depression, anxiety, and PTSD in parents after stillbirth compared to those of parents with live birth. Studies investigating predictors found that social support, marital status, negative appraisals, and variables related to care and management after stillbirth affected levels of symptoms.
Conclusions:
Parents who experience stillbirth have a considerably higher risk of reporting symptoms of depression, anxiety, and PTSD compared with parents with live births. More longitudinal studies are needed to increase our knowledge of how symptoms develop over time, and more research on fathers, transgender, non-binary and gender fluid individuals is needed. Research on the association between stillbirth and OCD is also warranted. Knowledge of the severity of anxiety, depression, and PTSD after stillbirth, and predictors associated with symptom severity could provide healthcare professionals with valuable information on how to provide beneficial postpartum care.
