A network analysis of post-traumatic stress disorder, anxiety, and depression in women with pregnancy loss

Background Pregnancy loss represents a significant public health concern within the realm of female reproductive health. In the current landscape of research, post-traumatic stress disorder (PTSD), anxiety, and depression are often investigated as an undifferentiated whole. However, this approach overlooks the unique symptomatic relationships and nuances that may exist among these mental health conditions in women who have endured pregnancy loss. Objective This study aimed to dissect the symptomatic interconnections among PTSD, anxiety, and depression in women who have experienced pregnancy loss. Methods A cross-sectional study was carried out at a tertiary hospital in Zhengzhou, China. Women with pregnancy loss were surveyed using a general information questionnaire, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Hospital Anxiety and Depression Scale. Network analysis techniques were employed to explore potential associations among these symptoms. Results Of the 691 women with pregnancy loss included in the analyses, PTSD entry 6 (Efforts to avoid thoughts and feelings that remind you of this matter) and PTSD entry 7 (Efforts to avoid conversations, people, places, and activities that remind you of this matter) had the strongest association, with a regularized partial correlation coefficient of 2.72. PTSD entry 7 was the most central symptom in the network, with a centrality strength of 1.79. Entry 5 (Thinking about this event causes physical reactions such as sweaty palms, muscle tension, shortness of breath, rapid heartbeat, dry mouth, stomach cramps, etc.) had the strongest bridging effect. The accuracy and stability of the network was tested to be better, and the network model was more reliable. Conclusions Through the innovative application of network analysis, this study successfully explored the associations between PTSD items and symptoms of anxiety and depression in women with pregnancy loss. By identifying the core and bridging symptoms, it provides valuable insights into the underlying mechanisms of these co-occurring mental health conditions.