Maternal posttraumatic stress disorder during the perinatal period and child outcomes: A systematic review

Cook, Natalie; Ayers, Susan; Horsch, Antje

doi:10.1016/j.jad.2017.07.045

Cited by 337 publications

(255 citation statements)

References 66 publications

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“…Early screening of women for postpartum PTSD might therefore be recommended, particularly for those women who also present with other risk factors identified in this study, such as maternal depression, lower level of education, higher body mass index, and an emergency cesarean. Early identification and treatment of women with postpartum PTSD may also facilitate the development of the mother‐infant bond and infant development …”

Section: Discussionmentioning

confidence: 99%

“…Early identification and treatment of women with postpartum PTSD may also facilitate the development of the mother-infant bond and infant development. 49 A key limitation of the study is the retrospective assessment of infant feeding, which may be subject to recall bias and the potential for social desirability. Other limitations are the relatively homogeneous, mainly Caucasian sample.…”

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confidence: 99%

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The influence of postpartum PTSD on breastfeeding: A longitudinal population‐based study

Garthus-Niegel

Horsch

Ayers

et al. 2017

Birth

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

The influence of postpartum PTSD on breastfeeding: A longitudinal population‐based study

Garthus-Niegel

Horsch

Ayers

et al. 2017

Birth

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“…Case studies and qualitative studies also suggest women with PTSD following childbirth may experience problems with bonding, for example with the initial rejection of the infant and delayed bonding (Ayers et al, 2006;Ballard et al, 1995). However, a review of 21 studies of postpartum PTSD and child outcomes concluded that there is inconsistent evidence for an effect of PTSD on mother-4 infant interaction, the mother-infant relationship or child development, and that studies conducted in this area were heterogeneous and limited methodologically (Cook et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

The role of posttraumatic stress and depression symptoms in mother-infant bonding

Radoš

Matijaš

Anđelinović

et al. 2020

Journal of Affective Disorders

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This is the accepted version of the paper.This version of the publication may differ from the final published version.Permanent repository link: https://openaccess.city.ac.uk/id/eprint/23962/ Link to published version: http://dx. AbstractBackground: There is some evidence posttraumatic stress disorder (PTSD) following childbirth may impact on the mother-infant bond. However, the evidence is inconsistent over whether PTSD or co-morbid depressive symptoms are primarily related to impaired bonding.This study therefore aimed to examine the relationship between PTSD symptoms, depressive symptoms and mother-infant bonding. Methods:A cross-sectional online study included 603 mothers of infants aged 1 to 12 months. Measures were taken of PTSD (City Birth Trauma Scale, Ayers et al., 2018) which has two subscales of birth-related PTSD symptoms and general PTSD symptoms; depression (Edinburgh Postnatal Depression Scale, Cox et al., 1987) and mother-infant bonding (Postpartum Bonding Questionnaire, Brockington et al., 2001). Results: Impaired bonding was related to both dimensions of PTSD symptoms and depressive symptoms in bivariate analysis. Path analysis testing the model of whether depressive symptoms mediated the effect of PTSD symptoms on mother-infant bonding found a differential role of birth-related and general PTSD symptoms. Birth-related PTSD symptoms did not have any effect on bonding or depressive symptoms. In contrast, general PTSD symptoms had a direct effect on bonding and an indirect effect on bonding via depressive symptoms. Limitations: Self-report measures of PTSD and depression symptoms were used. Conclusions: Further research regarding different aspects of postpartum PTSD, depression and other disorders in the context of mother-infant bonding are needed. Future preventive programs should focus on diminishing symptoms of postpartum PTSD and depression so that the motherinfant bonding remains optimal.Highlights  Both PTSD and depressive symptoms are related to impaired mother-infant bonding. A differential role of birth-related and general PTSD symptoms was found. Birth-related PTSD symptoms did not have effect on bonding or depressive symptoms. General PTSD symptoms had an indirect effect on bonding via depressive symptoms.

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“…Evidence shows that unique prenatal and postnatal attachment relationships are formed during each pregnancy (Brandon et al 2009). Investing in the prenatal attachment during this new pregnancy may help compensate for the traumatic birth experience and possible attachment difficulties the mother may have experienced with her previous child resulting from the traumatic childbirth experience (Cook et al 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Women with a negative experience of their childbirth report a longer delay until the next pregnancy and have fewer subsequent children compared with women who had a positive birth experience, with median time until next pregnancy of 4.2 vs. 2.4 years (Gottvall and Waldenstrom 2002). Some research shows that PTSD following childbirth interferes with the mother-infant attachment relationship, although the evidence is still inconclusive (Cook et al 2017). For example, one study found that maternal PTSD symptoms following childbirth were associated with distorted, inflexible, and negative mental representations of their children and a range of insensitive caregiving behaviors predictive of insecure attachment (Davies et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress symptoms following childbirth: associations with prenatal attachment in subsequent pregnancies

Garthus-Niegel

Horsch

Soest

et al. 2019

Arch Womens Ment Health

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PurposeThis longitudinal population-based study aimed to investigate the prospective relationship between PTSD symptoms following childbirth and prenatal attachment in the subsequent pregnancy. MethodsData were derived from the Norwegian Akershus Birth Cohort (ABC), a large population-based prospective cohort study. Data from 1,473 women who had given birth at least once before and who had completed questionnaires at 17 and 32 weeks of gestation were included. Confirmatory factor analysis of the short version of the Prenatal Attachment Inventory was conducted to validate the scale. Further, structural equation modeling techniques were used to estimate prospective associations of PTSD symptoms following childbirth with prenatal attachment.Finally, to explore potential mechanisms of the association, mediation and moderation analyses were conducted. ResultsPTSD symptoms following previous childbirth were found to be prospectively related to higher levels of prenatal attachment in the subsequent pregnancy, whilst controlling for important confounding factors, such as symptoms of maternal depression and anxiety, previous pregnancy loss, and sociodemographic factors (maternal age, educational level, marital status, and number of children). When fear of childbirth was included as a potential mediating variable, the prospective relationship between PTSD symptoms following childbirth and prenatal attachment 4 in the subsequent pregnancy increased, thereby indicating a suppressor effect. Fear of childbirth did not act as a significant moderator. ConclusionsOur findings suggest that a subsequent pregnancy following a traumatic childbirth may for some women represent an opportunity for a higher level of prenatal attachment, whereas high levels of fear of childbirth may be detrimental for prenatal attachment.

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Maternal posttraumatic stress disorder during the perinatal period and child outcomes: A systematic review

Cited by 337 publications

References 66 publications

The influence of postpartum PTSD on breastfeeding: A longitudinal population‐based study

The influence of postpartum PTSD on breastfeeding: A longitudinal population‐based study

The role of posttraumatic stress and depression symptoms in mother-infant bonding

Posttraumatic stress symptoms following childbirth: associations with prenatal attachment in subsequent pregnancies

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