Pregnant Women With Posttraumatic Stress Disorder and Risk of Preterm Birth

Yonkers, Kimberly A.; Smith, Megan V.; Forray, Ariadna; Epperson, C. Neill; Costello, Darcé; Lin, Haiqun; Belanger, Kathleen

doi:10.1001/jamapsychiatry.2014.558

Cited by 280 publications

(153 citation statements)

References 64 publications

(41 reference statements)

Supporting

Mentioning

139

Contrasting

Unclassified

Order By: Relevance

“…Regarding offspring physical effects, maternal PTSD and maternal prenatal stress, including psychosocial stress, maltreatment, and exposure to a terrorist attack, have been found to associate with impaired uterine blood flow, low birth weight, and pre-term birth (Wadhwa et al, 1993;Glover, 1997;Berkowitz et al, 2003;Lederman et al, 2004, Coussons-Read et al, 2012Cederbaum et al, 2013;Yonkers et al, 2014;Christiaens et al, 2015). Impaired uterine blood flow, low birth weight, and pre-term birth, in turn, have been linked with the subsequent development of hypertension, insulin resistance, Type 2 diabetes, and cardiovascular disease in adult offspring (Barker, 1998).…”

Section: Clinical Observations and Significancementioning

confidence: 99%

Intergenerational Transmission of Stress in Humans

Bowers

Yehuda

2015

Neuropsychopharmacol

394

269

View full text Add to dashboard Cite

The hypothesis that offspring are affected by parental trauma or stress exposure, first noted anecdotally, is now supported empirically by data from Holocaust survivor offspring cohorts and other populations. These findings have been extended to less extreme forms of stress, where differential physical, behavioral, and cognitive outcomes are observed in affected offspring. Parental stress-mediated effects in offspring could be explained by genetics or social learning theory. Alternatively, biological variations stemming from stress exposure in parents could more directly have an impact on offspring, a concept we refer to here as 'intergenerational transmission', via changes to gametes and the gestational uterine environment. We further extend this definition to include the transmission of stress to offspring via early postnatal care, as animal studies demonstrate the importance of early maternal care of pups in affecting offsprings' long-term behavioral changes. Here, we review clinical observations in offspring, noting that offspring of stress-or trauma-exposed parents may be at greater risk for physical, behavioral, and cognitive problems, as well as psychopathology. Furthermore, we review findings concerning offspring biological correlates of parental stress, in particular, offspring neuroendocrine, epigenetic, and neuroanatomical changes, in an attempt to determine the extent of parental stress effects. Although understanding the etiology of effects in offspring is currently impeded by methodological constraints, and limitations in our knowledge, we summarize current information and conclude by presenting hypotheses that have been prompted by recent studies in the field.

show abstract

Section: Clinical Observations and Significancementioning

confidence: 99%

Intergenerational Transmission of Stress in Humans

Bowers

Yehuda

2015

Neuropsychopharmacol

394

269

View full text Add to dashboard Cite

show abstract

“…If women have a history of PTSD it is also possible this can be re-triggered by events during pregnancy and birth (Halvorsen et al, 2013). A number of studies have shown that PTSD can have a negative impact on women, their relationship and birth outcomes (Nicholls and Ayers, 2007;Onoye et al, 2013;Shaw et al, 2014;Yonkers et al, 2014) and there are indications it may also affect infant emotion regulation and development (Bosquet Enlow et al, 2011;Parfitt et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…However, a number of gaps remain. Firstly, PTSD in pregnancy has not been reviewed despite evidence that it occurs in a significant proportion of women and is associated with poor outcomes such as preterm birth (Shaw et al, 2014;Yonkers et al, 2014). Secondly, all the reviews included studies of prevalence that were based on symptom severity scores rather than full diagnostic criteria which may inflate estimates.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis

Dikmen-Yildiz

Ayers

Phillips

2017

Journal of Affective Disorders

536

340

View full text Add to dashboard Cite

This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link AbstractBackground: Previous reviews have provided preliminary insights into risk factors and possible prevalence of post-traumatic stress disorder (PTSD) postpartum with no attempt to examine prenatal PTSD. This study aimed to assess the prevalence of PTSD during pregnancy and after birth, and the course of PTSD over this time.Methods: PsychINFO, PubMed, Scopus and Web of Science were searched using PTSD terms crossed with perinatal terms. Studies were included if they reported the prevalence of PTSD during pregnancy or after birth using a diagnostic measure. Limitations: Limitations include use of stringent diagnostic criteria, wide variability of PTSD rates, and inadequacy of studies on prenatal PTSD measured in three trimesters.Conclusions: PTSD is prevalent during pregnancy and after birth and may increase postpartum if not identified and treated. Assessment and treatment in maternity services is recommended.

show abstract

“…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.…”

Section: Discussionmentioning

confidence: 99%