Posttraumatic Stress Disorder and Pregnancy Health: Preliminary Update and Implications

Prenatal Care for Women Veterans Who Use Department of Veterans Affairs Health Care

“…The high rates of mental health morbidity are concerning because depression and PTSD are associated with an increased risk of adverse outcomes for both the mother and child (Grote et al, 2010;Morland et al, 2007;Seng, Low general population of pregnant women, the prevalence of PTSD is 8%, and prevalence of depression is estimated to be between 8% and 12% (Grote et al, 2010;Yonkers et al, 2014), whereas approximately 5% of pregnant women have a confirmed history of medically diagnosed depression (Bowers et al, 2013). In contrast, among women using VA prenatal benefits, rates of selfreported previous diagnosis of PTSD and depression were 9.8% and 62.5%, respectively, and approximately one-half screened positive for current PTSD or depression symptoms.…”

Evaluating PTSD on Reproductive Outcomes: Women Deployed in Iraq and Afghanistan

“…Morland et al evaluated the impact of PTSD on various health behaviors during pregnancy and found women with PTSD were more likely to smoke, abuse alcohol and drugs, and have peer prenatal care but the study did not have sufficient power to identify pregnancy outcomes [7]. A pilot study with 25 subjects did determine that women who experienced PTSD had lower basal salivary cortisol levels but they did not examine pregnancy outcomes [8].…”

Posttraumatic stress disorder, alcohol use, and physical health concerns

“…Second, it has been hypothesized that PTSD may indirectly affect health through changes in health behaviors. In particular, there is some evidence that negative changes in health behaviors, like increased alcohol use, smoking, decreases in exercise, and avoidance of medical care may be associated with PTSD (Dobie et al 2004;Lang et al 2003;Lawler et al 2005;Morland et al 2007;Ullman and Brecklin 2003;Ullman et al 2005). …”

“…Although it has been hypothesized that trauma exposure may lead to both problem drinking and to PTSD, and that these outcomes of trauma exposure lead to problems with physical health, few studies have specifically investigated PTSD, alcohol use, and health outcomes. Instead, studies have tended to (a) investigate only the relationship between trauma exposure, PTSD and alcohol but not consider physical health consequences (Breslau et al 1997;Breslau et al 2000;Kessler, Crum et al 1997;Kessler et al 1995;Kilpatrick et al 2000;Marx and Sloan 2003;Ouimette et al 1996;Stewart et al 2004) or (b) examine changes in health behaviors, as a group (e.g., examine alcohol use, smoking, and decreases in exercise as a single, combined variable), as a consequence of trauma exposure and PTSD rather than focusing more specifically on independent contributions to health outcomes (Dobie et al 2004;Lang et al 2003;Lawler et al 2005;Morland et al 2007;Ullman and Brecklin 2003;Ullman et al 2005). For example, in a study of women with substance use disorder diagnosis, PTSD was associated with significantly poorer functional health and well-being .…”