Post-traumatic stress disorder following childbirth: prevalence and associated factors—a prospective cohort study

Abstract

Objective Traumatic experiences during or after childbirth are subject of intense discussions in mainstream and social media as well as in scientific literature. Aim of this evaluation is to estimate the prevalence of post-traumatic stress disorder (PTSD) following childbirth in postpartum women and to evaluate the influence of maternal, obstetrical and neonatal characteristics on the degree of PTSD symptoms measured by the Impact of Events Scale questionnaire (IES-R). Methods In total, 589 women who gave birth in the University Medical Center Mainz, Germany in 2016, participated in a survey within the first days after birth. Of these, 278 also participated 6 months later. All participants received the validated Impact of Events Scale questionnaire (IES-R). The influence of maternal, obstetric and fetal parameters on PTSD score was evaluated. Results PTSD overall prevalence was 2.9%. Patients with PTSD had significantly less often personal support during labor (p < 0.001). Maternal age (p < 0.001), parity (p < 0.001), migration background (p < 0.001), mode of delivery (p < 0.001) and assistance during labor (p < 0.001) were parameters significantly influential on the PTSD symptom level measured by the IES-R. Conclusions Maternal PTSD prevalence after childbirth seems to be quite rare with 2.9%. Nevertheless, recent findings assume that this prevalence may only represent the “tip of the iceberg”. PTSD after childbirth should not be underestimated. As PTSD depends on personal vulnerability and existing risk factors, patients at risk have to be detected before childbirth, which appears to be challenging especially for obstetric and family care professionals.

„Hilflosigkeit, das Abgeben jeglicher Selbstverantwortung und Selbstbestimmtheit“ – eine qualitative Auswertung von traumatisierenden Geburtserlebnissen in Relation zum Geburtsmodus

“…Typisch sind sich aufdrängende Erinnerung oder Alpträume und eine wahrgenommene Isolation von der Familie [10]. Zur Diagnostik posttraumatischer Stressreaktionen bis hin zu einer child birth related PTSD wurden validierte Fragebögen wie der Impact of Events Scale Questionnaire (IES-R) [11,12] oder der City Birth Trauma Scale [13,14] entwickelt. Konkrete Auslöser oder Mechanismen sind bisher kaum untersucht, obwohl posttraumatische Stressreaktionen oder eine PTBS langfristigen Einfluss auf die MutterKind Beziehung oder die Partnerschaft haben [15] und die Wahl des künftigen Geburtsmodus beeinflussen können [16,17].…”

The global burden of perinatal common mental health disorders and substance use among migrant women: a systematic review and meta-analysis

“…Nine studies (n=2140; eight conducted in high-income host countries) assessed the prevalence of perinatal PTSD. [50][51][52][53][54]58,[161][162][163] Four presented data for women who are forced migrants. 50,54,58,162 The pooled prevalence of perinatal PTSD was 8•9% (range 3•2-33•3; I² 97•4%; τ² 0•18; appendix p 34).…”

Factors Associated with Obstetric Violence Implicated in the Development of Postpartum Depression and Post-Traumatic Stress Disorder: A Systematic Review

“…Regarding PTSD, 10 articles were found [33][34][35][36][37][38][39][40][41][42]. With respect to PPD, nine articles were found [43][44][45][46][47][48][49][50][51].…”