Reducing post-traumatic stress disorder (PTSD) and complicated grief (CG) after stillbirth (SB): a logic model-informed research agenda

Reducing post-traumatic stress disorder (PTSD) and complicated grief (CG) after stillbirth (SB): a logic model-informed research agenda

James A. McGregor (1,2), Janice I. French (2), Marti Perhach (1)

(1) Group B Strep International; (2) LA Best Babies Network

Background
PTSD and CG are poorly studied during and after pregnancy. Our objectives are to a) construct a logic model (LM) review and analysis and action plan for perinatal PTSD/CG and b) inform personal, family, medical provider, payor, policymaker and community means to prevent and reduce severity of PTSD/CG.

Methods
We used available electronic resources (PubMed. Google, Medline, others) to identify and analyze available research using the search terms “PTSD” and “complicated grief,” 1970’s to the present.

Results
A. PTSD in more common than clinically recognized (birth @4%).
B. Perinatal loss (4-7%)
C. Over 600 controlled trials regarding PTSD treatment were identified and included supportive, psychologic and physiologic behavioral treatments.
D. Complicated grief remains little studied.
E. PTSD and CG appear more common than recognized by clinicians.
F. Cognitive and behavioral approaches most commonly applied in non pregnancy-associated circumstances.
G. Few carefully controlled trials (Cochrane Analysis) or pharmalogic studies were identified.

Conclusion:
A. Research as to preventing and treating PTSD/CG in reproductive care is urgently needed.
B. Logic Model-informed approaches and risk remain to be identified for patients, providers, families, and communities.

Ethics statement:
No patients were involved. No institutional consent required/obtained.


International Stillbirth Alliance, Annual Conference on Perinatal Mortality and Bereavement Care, Madrid, Spain. October 5-6th, 2019.

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