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

Abstract

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.

Parental Birth-Related PTSD Symptoms and Bonding in the Early Postpartum Period: A Prospective Population-Based Cohort Study

“…The mother-infant bond following childbirth is an important facilitator of optimal infant development ( 2 ). It is thought to first appear during pregnancy or shortly after birth and then to develop over the first few months postpartum ( 3 , 4 ). Thus, it is important to understand the factors that may shape it, both during the prenatal and postpartum period.…”

The Lausanne Infant Crying Stress Paradigm: Validation of an Early Postpartum Stress Paradigm with Women at Low vs. High Risk of Childbirth-Related Posttraumatic Stress Disorder

“…Besides the maternal distress and interference with everyday functioning due to CB-PTSD symptoms [9], CB-PTSD can negatively affect the couple relationship [20,21] and subsequent future reproductive experiences [22,23]. Maternal CB-PTSD symptoms may also be associated with child sleep problems [22,24], breastfeeding initiation and continuation [22,25], and, potentially, with problems regarding the mother-infant relationship or bonding [22,26].…”

Messinstrumente zur Erfassung von Bindungsaufbau während Schwangerschaft und nach der Geburt (Teil 3 einer Serie zur psychologischen Diagnostik im Peripartalzeitraum)

“…Hervorzuheben ist weiterhin der Zusammenhang von psychischen Beschwerden der Eltern mit Schwierigkeiten beim Bindungsaufbau. Sowohl für Symptome von Angst und Depression, ausgeprägter Geburtsangst als auch von posttraumatischer Belastungsstörung lassen sich Verringerungen in der Bindungsqualität sowie Probleme beim Aufbau von Bindung zum Kind vermuten [12][13][14][15][16][17]. Gerade für potentiell stärker belastete Populationen, wie die Eltern von Frühgeborenen, sollten diese Erkenntnisse berücksichtigt werden.…”