The impact of grief on post-traumatic stress reactions among perinatal loss women: A moderated mediation model of perinatal depression and anxiety, and social support

Abstract

Abstract Background Post-traumatic stress response reactions are prevalent mental phenomenon in perinatal loss women due to high grief, high perinatal depression and anxiety or low social support. Although post-traumatic stress reactions are known to have serious negative implications for perinatal loss women, families and society, the mechanism through which it functions is less clear. Methods This study was a multicentre cross-sectional survey conducted from December 2021 to October 2022, involving 346 perinatal loss women as participants. The Pearson’s correlation analysis, the PROCESS Macro Model 4 and Model 14 on SPSS (version 26) were used to analyse the available data. Results Perinatal grief positively predicted post-traumatic stress reactions among perinatal loss women. Perinatal depression and anxiety mediated the relationship between perinatal grief and post-traumatic stress reactions. Meanwhile, this process was moderated by social support. Conclusions The higher the level of grief among perinatal loss women, the more likely post-traumatic stress reactions. As a mediating mechanism with moderating, social support and perinatal depression and anxiety further explained how perinatal grief affected the post-traumatic stress reactions. In the higher social support, there was a weaker positive relationship between perinatal depression and anxiety, and post-traumatic stress reactions, compared to situations with lower social support. Nurses and midwives can help reduce the post-traumatic stress reactions among perinatal loss women by alleviating their perinatal depression and anxiety, and perinatal grief and by providing adequate medical and emotional support.