Posttraumatic stress disorder after second-trimester medical termination of pregnancy
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To evaluate the risk of posttraumatic stress disorder after indicated second-trimester termination of pregnancy and to identify factors associated with a probable diagnosis of severe posttraumatic stress disorder. STUDY DESIGN: weeks of gestation. Posttraumatic stress disorder was evaluated by the Impact of Event Scale-Revised questionnaire, self-administered 1 to 4 months after termination of pregnancy. This 22-item scale is designed to assess subjective distress caused by traumatic events and has been validated in perinatal care. The literature suggests that a score ≥33 indicates a probable diagnosis of posttraumatic stress disorder and a score ≥37 a probable diagnosis of severe posttraumatic stress disorder. Maternal and obstetric characteristics associated with a score ≥37 were studied with mixed models. We present results after multiple imputation to take selective dropouts and missing information at follow-up into account and for complete cases. RESULTS: Among the 347 women enrolled, 247 (71.2%) Impact of Event Scale-Revised questionnaires were available. Median time between termination of pregnancy and completion of the questionnaire was 7 weeks (interquartile range, 4.9-13.3). The mean Impact of Event Scale-Revised score was 32.1 (standard deviation, 15.4). The Impact of Event Scale-Revised score was ≥33 for 44.9% (95% confidence interval, 38.4-51.4) of women and ≥37 for 35.8% (95% confidence interval, 29.7-41.8). After multivariate analysis, obstetric or labor-related characteristics such as parity, gestational age over 22 weeks, use of cervical dilators, labor >12 hours, and pain or complications during delivery or postpartum were not associated with an Impact of Event Scale-Revised score ≥37. The results were similar in complete cases. CONCLUSION: Nearly half of women undergoing medically indicated second-trimester termination of pregnancy were at risk of posttraumatic stress disorder and more than one-third of severe posttraumatic stress disorder. The absence of risk factors underlines the potential benefits of systematic psychological evaluation after termination of pregnancy for all women.
Authors: Olivia Anselem, Alexandre J. Vivanti, Hanane Bouchghoul, Thibault Quibel, Norbert Winer, Jean-Marie Jouannic, Vanina Castaigne, Estelle Perdriolle-Galet, Jérôme Massardier, Jessica Rousseau, Rahmethnissah Radjack, Vassilis Tsatsaris, Pierre-Yves Ancel, François Goffinet, O. Anselem, V. Tsatsaris, F. Goffinet, J.M. Jouannic, L. Guilbaud, N. Winer, C. Arthuis, C. Georgelin, H. Bouchghoul, M.V. Sénat, A.J. Vivanti, A. Benachi, P. Rozenberg, N. Hot, J. François, E. Perdriolle-Galet, O. Morel, V. Castaigne, J. Massardier, C. Thong Vanh, P.Y. Ancel, L. Lecomte, J. Rousseau, H. Abdoul
Institutions: Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Maternité Port Royal, Hôpital Antoine-Béclère, Bicêtre Hospital, Inserm, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, Centre de recherche en Epidémiologie et Santé des Populations, Centre Hospitalier Universitaire de Nantes, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, PhysioPathologie des Adaptations Nutritionnelles, Université de Nantes, Nantes Université, Sorbonne Université, Hôpital Armand-Trousseau, Centre Hospitalier Régional et Universitaire de Nancy, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Université Paris Cité, Université Sorbonne Paris Nord, Centre de Recherche Épidémiologie et Statistique
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,410
Award: G2634865547
OpenAlex ID: W7130747610