Predictors of posttraumatic stress symptoms following childbirth

Abstract

BackgroundPosttraumatic stress disorder (PTSD) following childbirth has gained growing attention in the recent years. Although a number of predictors for PTSD following childbirth have been identified (e.g., history of sexual trauma, emergency caesarean section, low social support), only very few studies have tested predictors derived from current theoretical models of the disorder. This study first aimed to replicate the association of PTSD symptoms after childbirth with predictors identified in earlier research. Second, cognitive predictors derived from Ehlers and Clark’s (2000) model of PTSD were examined.MethodsN = 224 women who had recently given birth completed an online survey. In addition to computing single correlations between PTSD symptom severities and variables of interest, in a hierarchical multiple regression analyses posttraumatic stress symptoms were predicted by (1) prenatal variables, (2) birth-related variables, (3) postnatal social support, and (4) cognitive variables.ResultsWellbeing during pregnancy and age were the only prenatal variables contributing significantly to the explanation of PTSD symptoms in the first step of the regression analysis. In the second step, the birth-related variables peritraumatic emotions and wellbeing during childbed significantly increased the explanation of variance. Despite showing significant bivariate correlations, social support entered in the third step did not predict PTSD symptom severities over and above the variables included in the first two steps. However, with the exception of peritraumatic dissociation all cognitive variables emerged as powerful predictors and increased the amount of variance explained from 43% to a total amount of 68%.ConclusionsThe findings suggest that the prediction of PTSD following childbirth can be improved by focusing on variables derived from a current theoretical model of the disorder.

Transtorno do estresse pós-traumático no puerpério em uma maternidade de alto risco fetal no Município do Rio de Janeiro, Brasil

“…Contrary to expectations 24 , PTSD prevalence did not differ based on socio-demographic characteristics or reproductive history, with the exception of parity. Women with a history of three or more births showed nearly twofold prevalence of postpartum PTSD when compared to women with fewer children.…”

The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework

“…It is likely there are variables that warrant further exploration which are not analysed here because of insufficient evidence. For example, cognitive appraisals after birth (Ford et al, 2010;Vossbeck-Elsebusch et al, 2014), anxiety sensitivity (Keogh, Ayers, & Francis, 2002;Verreault et al, 2012) and insomnia (Garthus-Niegel, Ayers, von Soest, Torgersen & Eberhard-Gran, 2014) all appear promising but there was not enough evidence to include them in the metaanalysis. Future research should therefore consider other variables, such as these, which are not included in this review.…”

Repetitive Negative Thinking and Its Role in Perinatal Mental Health

“…This speaks to the importance of investigating RNT broadly (i.e., rumination as well as worry) during pregnancy, and investigating whether specific subtypes of RNT are predictive of levels of depression and anxiety later in pregnancy. Indeed, Vossbeck-Elsebusch et al [31] demonstrated that RNT following childbirth predicted anxiety in the form of posttraumatic stress disorder symptoms, replicating the well-established predictive capacity of rumination in predicting posttraumatic stress disorder in the trauma literature. To our knowledge, the hypothesis that RNT predicts other perinat al anxiety disorders (e.g., obsessive-compulsive disorder) has not been subject to empirical test.…”