The Other Postpartum: Depression, Anxiety, and Post-Traumatic Stress Disorder following Stillbirth and Neonatal Death

2023 Award: $45,791

Each year, 1% of all live birth will be stillborn or result in neonatal death. The women and families that suffer these losses are at increased risk of anxiety, depression, and PTSD; however, their outcomes remain understudied, underrecognized, and undertreated. The grant allows us to begin to prospectively follow these women to begin to lay the groundwork for further investigation into biological risks, prevention, and best interventions.

Need/Problem: Stillbirth and neonatal demise affects 1% of all live births. The repercussions of these losses have been understudied and undertreated, leaving many women and families to suffer without clear guidance and treatment options.

Grant Summary: We will prospectively map the course depression, anxiety, and Post Traumatic Stress Disorder (PTSD) following stillbirth and neonatal loss and, for the first time, evaluating stress responsiveness in the year post-loss. We will additionally evaluate health care utilization. Ecological momentary assessment will be used to track symptom and heart rate variability with salivary cortisol and alpha-amylase will be collected at three times points to assess stress reactivity.

Goals and Projected Outcomes: This study will provide preliminary data to inform future translational research into risk as well as interventions that prevent and treat anxiety, depression, and PTSD following loss. Future studies will expand to include miscarriage, which occurs in up to 25% of all pregnancies.

Julia Riddle, MD

Grant Details: Stillbirth and neonatal loss impact 1% of all live births in the United States. Following these losses, patient-reported data indicated a 4-fold risk of depression, a 7-fold risk of PTSD, and increased risk of suicide. This population, however, remains understudied and undertreated. This study will lay the groundwork for further investigation of prevention, recognition, and treatment of mental illness following stillbirth and neonatal loss.