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Post-traumatic stress disorder and management of stillbirth

Published online by Cambridge University Press:  02 January 2018

P. Turton
Affiliation:
Parent Child Research Group, Department of Psychiatry, Jenner Wing, St George's Hospital Medical School, London SW17 0RE, UK
P. Hughes
Affiliation:
Parent Child Research Group, Department of Psychiatry, Jenner Wing, St George's Hospital Medical School, London SW17 0RE, UK
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Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2002 

Lovett (Reference Lovett2001), commenting on our article ‘Incidence, correlates and predictors of post-traumatic stress disorder in the pregnancy after stillbirth’ (Reference Turton, Hughes and EvansTurton et al, 2001) took issue with our reporting a possible association between post-traumatic stress disorder and holding the dead infant which did not reach statistical significance.

We should like to make two points. First, we were at pains to make it clear that numbers were small and not significant statistically. Second, although your correspondent could not know this at the time of writing, we have subsequently published a paper reporting a significant relationship between seeing the dead infant and disorganisation of mother—infant attachment in the next-born child at the age of 12 months (Reference Hughes, Turton and HopperHughes et al, 2001). This was an unexpected finding for us.

Our main concern is that a profound change in clinical practice (seeing and holding the dead infant) was introduced with great enthusiasm in maternity units in the UK and elsewhere on the basis of limited and non-systematic clinical observation. Our published findings to date do not offer any evidence in support of this practice. We concur with Dr Lovett that this is an area which demands further investigation and rigorous evaluation.

Footnotes

EDITED BY MATTHEW HOTOPF

References

Hughes, P., Turton, P., Hopper, E., et al (2001) Disorganised attachment behaviour among infants born subsequent to stillbirth. Journal of Child Psychology and Psychiatry, 42, 791801.CrossRefGoogle ScholarPubMed
Lovett, K. F. (2001) PTSD and stillbirth (letter). British Journal of Psychiatry, 179, 367.CrossRefGoogle Scholar
Turton, P., Hughes, P., Evans, C. D. H., et al (2001) Incidence, correlates and predictors of post-traumatic stress disorder in the pregnancy after stillbirth. British Journal of Psychiatry, 178, 556560.CrossRefGoogle ScholarPubMed
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