(1) Examiner les expériences de femmes ayant déjà accouché de mort-nés et évaluer les soins qu’elles ont reçus à l’hôpital. (2) Évaluer le niveau à long terme des symptômes de stress post-traumatique (SPT) dans ce groupe et identifier les facteurs de risque pour ce résultat.
Conception
Une étude rétrospective.
Réglage
Deux hôpitaux universitaires.
Participants
La population de l’étude comprenait 379 femmes ayant reçu un diagnostic confirmé de mortinatalité (≥ 23 semaines de gestation ou de poids à la naissance ≥ 500 g) au cours d’une grossesse singleton ou gémellaire de 5 à 18 ans. 101 femmes ont rempli un questionnaire complet en deux parties.
Mesures de résultats primaires et secondaires
Les expériences des femmes et l’évaluation des soins fournis par les professionnels de la santé avant, pendant et après la mortinaissance. Le SPT au suivi a été évalué à l’aide de l’échelle d’impact des événements (IES).
Résultats
La grande majorité a vu (98%) et tenu (82%) leur bébé. La plupart des femmes ont estimé que les professionnels de la santé étaient favorables à l’accouchement (85,6%) et montraient du respect pour leur bébé (94,9%). La majorité (91,1%) avaient reçu une forme de suivi à court terme. Un tiers présentait une SPT à long terme cliniquement significative (IES ≥ 20). Les facteurs de risque indépendants étaient l’âge plus jeune (OR 6,60, IC 95% : 1,99 à 21,83), l’avortement provoqué avant la mortinaissance (OR 5,78, IC 95%, 1,56 à 21,38) et la parité supérieure (OR 3,46, IC 95%, 1,19 à 10,07) à la naissance. temps de mortinaissance. Le fait d’avoir tenu le bébé (OR 0,17, IC95% 0,05 à 0,56) était associé à moins de SPT. Conclusions
La grande majorité a vu et tenu son bébé et était satisfaite du soutien des professionnels de la santé. Une femme sur trois présentait un niveau cliniquement significatif de SPT 5-18 ans après la mortinaissance. Avoir tenu le bébé était protecteur, alors que l’avortement provoqué antérieur était un facteur de risque pour un niveau élevé de SPT.
Abstract (English)
:
Objectives
(1) To investigate the experiences of women with a previous stillbirth and their appraisal of the care they received at the hospital. (2) To assess the long-term level of post-traumatic stress symptoms (SPT) in this group and identify risk factors for this outcome.
Design
A retrospective study.
Setting
Two university hospitals.
Participants
The study population comprised 379 women with a verified diagnosis of stillbirth (≥23 gestational weeks or birth weight ≥500 g) in a singleton or twin pregnancy 5–18 years previously. 101 women completed a comprehensive questionnaire in two parts.
Primary and secondary outcome measures
The women’s experiences and appraisal of the care provided by healthcare professionals before, during and after stillbirth. SPT at follow-up was assessed using the Impact of Event Scale (IES).
Results
The great majority saw (98%) and held (82%) their baby. Most women felt that healthcare professionals were supportive during the delivery (85.6%) and showed respect towards their baby (94.9%). The majority (91.1%) had received some form of short-term follow-up. One-third showed clinically significant long-term SPT (IES ≥ 20). Independent risk factors were younger age (OR 6.60, 95% CI 1.99 to 21.83), induced abortion prior to stillbirth (OR 5.78, 95% CI 1.56 to 21.38) and higher parity (OR 3.46, 95% CI 1.19 to 10.07) at the time of stillbirth. Having held the baby (OR 0.17, 95% CI 0.05 to 0.56) was associated with less PTSS. Conclusions
The great majority saw and held their baby and were satisfied with the support from healthcare professionals. One in three women presented with a clinically significant level of SPT 5–18 years after stillbirth. Having held the baby was protective, whereas prior induced abortion was a risk factor for a high level of SPT.
Sumário (português)
:
Objetivos
(1) Investigar as experiências de mulheres com natimorto anterior e sua avaliação dos cuidados que receberam no hospital. (2) Avaliar o nível de longo prazo dos sintomas de estresse pós-traumático (SPT) nesse grupo e identificar fatores de risco para esse resultado.
desenhar
Um estudo retrospectivo.
Configuração
Dois hospitais universitários.
Participantes
A população do estudo compreendeu 379 mulheres com um diagnóstico verificado de natimorto (≥23 semanas gestacionais ou peso ao nascer ≥500 g) em uma gravidez única ou gemelar, 5 a 18 anos antes. 101 mulheres preencheram um questionário abrangente em duas partes.
Medidas de resultado primário e secundário
As experiências das mulheres e a avaliação dos cuidados prestados pelos profissionais de saúde antes, durante e após o parto. O PTSS no seguimento foi avaliado usando a escala Impact of Event (IES).
Resultados
A grande maioria viu (98%) e segurou (82%) o bebê. A maioria das mulheres sentiu que os profissionais de saúde apoiavam o parto (85,6%) e demonstravam respeito pelo bebê (94,9%). A maioria (91,1%) recebeu algum tipo de acompanhamento de curto prazo. Um terço apresentou SPT a longo prazo clinicamente significativo (IES ≥ 20). Os fatores de risco independentes foram idade mais jovem (OR 6,60, IC 95% 1,99 a 21,83), aborto induzido antes do natimorto (OR 5,78, IC 95% 1,56 a 21,38) e maior paridade (OR 3,46, IC 95% 1,19 a 10,07) tempo de natimorto. Ter mantido o bebê (OR 0,17, IC 95% 0,05 a 0,56) foi associado a menos TEPT.
Conclusões
A grande maioria viu e segurou o bebê e ficou satisfeita com o apoio dos profissionais de saúde. Uma em cada três mulheres apresentou um nível clinicamente significativo de SPT 5 a 18 anos após o nascimento de um bebê morto. Manter o bebê era protetor, enquanto o aborto induzido prévio era um fator de risco para um alto nível de SPT.
Resumen (español)
:
Full text (public) :
Comments :
Argument
(français) :
La grande majorité a vu (98%) et tenu (82%) leur bébé. La plupart des femmes ont estimé que les professionnels de la santé étaient favorables lors de l’accouchement (85,6%) et montraient du respect pour leur bébé (94,9%). La majorité (91,1%) avaient reçu une forme de suivi à court terme. Un tiers présentait un Stress Post-Traumatic à long terme cliniquement significative (IES ≥ 20).
Argument
(English):
The vast majority saw (98%) and held (82%) their baby. Most women felt that health professionals were supportive during delivery (85.6%) and showed respect for their baby (94.9%). The majority (91.1%) had received some form of short-term follow-up. One-third had a clinically significant long-term Stress Post-Traumatic (IES ≥ 20).
Argumento
(português):
A grande maioria viu (98%) e segurou (82%) o bebê. A maioria das mulheres sentiu que os profissionais de saúde apoiavam o parto (85,6%) e demonstravam respeito pelo bebê (94,9%). A maioria (91,1%) recebeu algum tipo de acompanhamento de curto prazo. Um terço apresentou um SPT de longo prazo clinicamente significativo (IES ≥ 20).
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