Perinatal factors related to post-traumatic stress disorder symptoms 1–5 years following birth

et al. 2021

JPM

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To determine the association between experiencing obstetric violence and the incidence of postpartum post-traumatic stress disorder (PTSD). A cross-sectional study with puerperal women was conducted in Spain following ethical approval. The Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) was administered online. Sociodemographic, clinical, and obstetric violence variables and the risk of dichotomized PTSD (low/high) were studied by bivariate and multivariate analysis with binary logistic regression. 955 women were invited to participate. 53 women refused to participate, three did not complete all survey questions and, finally, 899 women were included. The risk of PTSD (score ≥ 19) using the PPQ was 12.7% (114). The mean score was 9.10 points (SD = 8.52). Risk factors identified were having a delivery plan that was not respected (aOR: 2.85, 95% CI 1.56–5.21), elective caesarean delivery (aOR: 2.53, 95% CI 1.02–2.26), emergency caesarean section (aOR: 3.58, 95% CI 1.83–6.99), admission of the newborn to the neonatal intermediate care unit (aOR: 4.95, 95% CI 2.36–10.36), admission to the intensive care unit (aOR: 2.25, 95% CI 1.02–4.97), formula feeding on discharge (aOR: 3.57, 95% CI 1.32–9.62), verbal obstetric violence (aOR: 5.07, 95% CI 2.98–8.63), and psycho-affective obstetric violence (aOR: 2.61, 95% CI 1.45–4.67). Various clinical practices were identified with the risk of PTSD, highlighting various types of obstetric violence. Partner support and early breastfeeding were identified as protective factors. Sensitizing professionals is essential to prevent the risk of PTSD.

Section: Introductionmentioning

confidence: 99%

Factors Associated with Postpartum Post-Traumatic Stress Disorder (PTSD) Following Obstetric Violence: A Cross-Sectional Study

et al. 2021

JPM

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“…Along similar lines, the risk was also related to the lack of skin-to-skin contact and formula feeding. Although these variables have not been included in other models, they have been related to an increased risk of PTSD in other studies [2,7,15,35]. Although these three variables are related to each other, the authors believe that they also have a partially independent effect.…”

Section: Discussionmentioning

confidence: 94%

“…Concerning these models, we agree on the inclusion of the variable "type of delivery" as a predictive factor of PTSD risk [9,18,23]; specifically, instrumental delivery [9] and emergency cesarean section [9,18] as they present forms of childbirth with the greatest risks. Although multiple studies associate the type of delivery with the risk of PTSD [7][8][9][10][11][12][13][14][15], and the presence of perineal tears [13,18,34], no predictive models have been developed that include these.…”

Section: Discussionmentioning

confidence: 99%

“…However, research into the obstetric factors involved in PTSD development is scarce. Most studies focus on the influence of birth type [7][8][9][10][11][12][13][14][15] and newborn variables such as prematurity [16,17], low weight [16], low Apgar scores [16,18], type of newborn feeding [7], and newborn hospitalization [9]. Several studies have recently observed a relationship between certain obstetric practices and the risk of PTSD [2,15].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Elaboration and Validation of Two Predictive Models of Postpartum Traumatic Stress Disorder Risk Formed by Variables Related to the Birth Process: A Retrospective Cohort Study

et al. 2020

IJERPH

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This study aimed to develop and validate two predictive models of postpartum post-traumatic stress disorder (PTSD) risk using a retrospective cohort study of women who gave birth between 2018 and 2019 in Spain. The predictive models were developed using a referral cohort of 1752 women (2/3) and were validated on a cohort of 875 women (1/3). The predictive factors in model A were delivery type, skin-to-skin contact, admission of newborn to care unit, presence of a severe tear, type of infant feeding at discharge, postpartum hospital readmission. The area under curve (AUC) of the receiver operating characteristic (ROC) in the referral cohort was 0.70 (95% CI: 0.67–0.74), while in the validation cohort, it was 0.69 (95% CI: 0.63–0.75). The predictive factors in model B were delivery type, admission of newborn to care unit, type of infant feeding at discharge, postpartum hospital readmission, partner support, and the perception of adequate respect from health professionals. The predictive capacity of model B in both the referral cohort and the validation cohort was superior to model A with an AUC-ROC of 0.82 (95% CI: 0.79–0.85) and 0.83 (95% CI: 0.78–0.87), respectively. A predictive model (model B) formed by clinical variables and the perception of partner support and appropriate treatment by health professionals had a good predictive capacity in both the referral and validation cohorts. This model is preferred over the model (model A) that was formed exclusively by clinical variables.

“…The questionnaire presents an adequate convergent validity as is associated with variables linked previously with PTSD risk, such as type of birth 11,12,[23][24][25][26][27][28][29][30] , prematurity 5,31 , neonatal admission to care unit 25 , skin-to-skin 11 , and type of feeding 23 . Furthermore, other associations with PTSD risk were observed, including the degree of partner support and feeling respected by healthcare staff.…”

Section: Discussionmentioning

confidence: 99%

Validation of perinatal post-traumatic stress disorder questionnaire for Spanish women during the postpartum period

et al. 2021

Sci Rep

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To determine the psychometric properties of the Perinatal Post-Traumatic Stress Disorder (PTSD) Questionnaire (PPQ) in Spanish. A cross-sectional study of 432 Spanish puerperal women was conducted, following ethical approval. The PPQ was administered online through midwives' associations across Spain. The Edinburgh Postnatal Depression Scale was used to diagnose postnatal depression for examining criterion validity. Data were collected on sociodemographic, obstetric, and neonatal variables. An exploratory factorial analysis (EFA) was performed with convergence and criterion validation. Internal consistency was evaluated using Cronbach's α. The EFA identified three components that explained 63.3% of variance. The PPQ's convergence validation associated the risk of PTSD with variables including birth plan, type of birth, hospital length of stay, hospital readmission, admission of the newborn to care unit, skin-to-skin contact, maternal feeding at discharge, maternal perception of partner support, and respect shown by healthcare professionals during childbirth and puerperium. The area under the ROC curve for the risk of postnatal depression (criterion validity) was 0.86 (95% CI 0.82–0.91). Internal consistency with Cronbach's α value was 0.896. The PPQ used when screening for PTSD in postpartum Spanish women showed adequate psychometric properties.