Childhood Abuse History, Posttraumatic Stress Disorder, Postpartum Mental Health, and Bonding: A Prospective Cohort Study

Abstract

Introduction Research is needed that prospectively characterizes the intergenerational pattern of effects of childhood maltreatment and lifetime posttraumatic stress disorder (PTSD) on women’s mental health in pregnancy and on postpartum mental health and bonding outcomes. This prospective study included 566 nulliparous women in 3 cohorts: PTSD-positive, trauma-exposed resilient, and non-exposed to trauma. Methods Standardized telephone interviews with women who were less than 28 gestational weeks ascertained trauma history, PTSD diagnosis, and depression diagnosis. A six-week postpartum interview reassessed interim trauma, labor experience, PTSD, depression, and bonding outcomes. Results Regression modeling indicates posttraumatic stress in pregnancy, alone, or comorbid with depression, is associated with postpartum depression (R2=.204, P<.001). Postpartum depression alone, or comorbid with posttraumatic stress, was associated with impaired bonding (R2=.195, P<.001). In both models, higher quality of life ratings in pregnancy were associated with better outcomes, while reported dissociation in labor was a risk for worse outcomes. The effect of a history of childhood maltreatment on both postpartum mental health and bonding outcomes was mediated by pre-existing mental health status. Discussion Pregnancy represents an opportune time to interrupt the pattern of intergenerational transmission of abuse and psychiatric vulnerability. Further dyadic research is warranted beyond six weeks postpartum. Trauma-informed interventions for women who enter care with abuse-related PTSD or depression should be developed and tested.

Culturally relevant treatment services for perinatal depression in socio-economically disadvantaged women: The design of the MOMCare study

“…103,104,105 Childhood trauma also predicts a 12-fold risk of having PTSD in pregnancy and is associated with a comorbidity of PTSD and depression during pregnancy. 126 PTSD has been found to affect from 8% - 33% of pregnant and parenting women, 95,127 and, if comorbid with antenatal depression, appears to be associated with a 4-fold increased risk of preterm birth. 128 …”

Perceptions of general and parenting-specific posttraumatic change among postpartum mothers with histories of childhood maltreatment

“…Moreover, PTC are open to modification across developmental and life experiences (Harvey, Mishler, Koenen, & Harney, 2000). The current study examines PTC during the transition to motherhood, a time when many revisit their childhood maltreatment experiences (Seng et al, 2013). …”

“…For women with CM histories, revisiting these experiences might prompt renewed consideration of the meanings of these experiences for general as well as parenting specific views of the self, relationships, and world. Such contemplation might provide an opportunity to restore meaning in life, or renew hopefulness but might also raise concerns about oneself as a competent parent, the parent–child relationship, or more general views about parenting (Banyard, 1997; Seltmann & Wright, 2013; Seng et al, 2013; Wright, Fopma-Loy, & Oberle, 2012). In this way, CM may shape both general and parenting-specific models of the self, others, and the world (Park, 2010).…”

Intergenerational trauma framework for programme efficacy studies: child trauma recovery in occupied Palestine

“…This desire to carry on the stories of the Holocaust supports the suggestion by Duran and Duran (1995) that traumatic narratives can be sustained by the normal mechanisms that perpetuate other cultural traditions and beliefs across generations. More apparent evidence of how the effects of trauma are passed from one generation to the next is provided by Seng et al, (2013). In a study of the effects of PTSD and depression in expectant mothers on postpartum mental health and mother-child bonding, researchers found that mothers with pre-natal PTSD, or both pre-natal PTSD and depression, were more likely than their mentally healthy counterparts to experience postpartum depression.…”