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Psychological complications after stillbirth--influence of memories and immediate management: population based study
I Rådestad1, G Steineck, C Nordin
1Centre for Caring Sciences North, Karolinska Institute, Stockholm, Sweden.
Objective:
To identify factors that may predict long term psychological complications among women who have had a stillborn child.
Design:
Nationwide population based study using epidemiological methods.
Subjects:
380 subjects and 379 controls who had had a stillborn or non-deformed live child in Sweden in 1991.
Results:
Information was provided by 636 (84%) women. The ratio (95% confidence interval) of proportions of women with symptoms related to anxiety above the 90th centile for women who had had a stillborn child compared with those who had not was 2.1 (1.2 to 3.9). An interval of 25 hours or more from the diagnosis of death in utero to the start of delivery gave a ratio of 4.8 (1.5 to 15.9). The ratio was 2.3 (1.1 to 5.3) for not seeing the child as long as the mother had wished and 3.1 (1.6 to 6.0) for no possession of a token of remembrance.
Conclusion:
It is advisable to induce the delivery as soon as feasible after the diagnosis of death in utero. A calm environment for the woman to spend as much time as she wants with her stillborn child is beneficial, and tokens of remembrance should be collected.