Abstract
BACKGROUND/OBJECTIVES: Miscarriage (spontaneous abortion) can precipitate post-traumatic stress disorder (PTSD). In Peru, post-loss mental healthcare is limited. We aimed to identify factors associated with PTSD symptoms persisting ≥ 3 months among women who experienced miscarriage and were treated in the emergency department (ED) of a national hospital in Lima, 2021-2023. METHODS: We conducted a cross-sectional analytical study of 214 women with spontaneous abortion seen in the ED (January 2021-December 2023). PTSD symptoms were measured with the PTSD Checklist for DSM-5 (PCL-5), anchored to the miscarriage index; sociodemographic and gyneco-obstetric variables were obtained with a validated questionnaire. Multivariable Poisson regression with robust variance estimated the adjusted prevalence ratios (aPRs). RESULTS: Probable PTSD (PCL-5 ≥ 33) was present in 52.8% of participants. Independent correlates included previous miscarriage (aPR 1.75; 95% CI 1.35-2.25), ≥2 pre-gestational medical visits (aPR 1.66; 95% CI 1.21-2.27), and one (aPR 1.36; 95% CI 1.00-1.84) or multiple comorbidities (aPR 1.61; 95% CI 1.12-2.30). No other sociodemographic or obstetric variables were significantly associated. CONCLUSIONS: More than half of women assessed ≥ 3 months after miscarriage screened positive for probable PTSD. Previous pregnancy loss increased pre-gestational healthcare contact, and medical comorbidities were associated with higher prevalence. Integrating routine mental health screening and trauma-informed support within ED and reproductive health services could improve detection and care for this population. To our knowledge, this is the first ED-based study in Peru to examine factors associated with post-loss probable PTSD (PCL-5 ≥ 33) after miscarriage.