Prevalences and predictive factors of maternal trauma through 18 months after premature birth: A longitudinal, observational and descriptive study.

Emilie Brunson,Alexandre Novo,Laurianne Vulliez-Coady,Fabienne Ligier,Anne-Catherine Rolland,Aurore Thierry,Julien Eutrope,Andrew Sharp

doi:10.1371/journal.pone.0246758

Abstract

Posttraumatic reactions are common among mothers of preterm infants and can have a negative influence on their quality of life and lead to interactional difficulties with their baby. Given the possible trajectories of posttraumatic reactions, we hypothesized that prevalences of postpartum posttraumatic reactions at given times underestimate the real amount of mothers experiencing these symptoms within 18 months following delivery. Additionally, we examined whether sociodemographic and clinical characteristics of dyads influence the expression of posttraumatic symptoms among these mothers. A sample of 100 dyads was included in this longitudinal study led by 3 french university hospitals. Preterm infants born before 32 weeks of gestation and their mothers were followed-up over 18 months and attended 5 visits assessing the infants’ health conditions and the mothers’ psychological state with validated scales. Fifty dyads were retained through the 18 months of the study. The period prevalence of posttraumatic reactions was calculated and a group comparison was conducted to determine their predictive factors. Thirty-six percent of the mothers currently suffered from posttraumatic symptoms 18 months after their preterm delivery. The 18 months period prevalence was 60.4% among all the mothers who participated until the end of the follow-up. There was a statistical link between posttraumatic symptoms and a shorter gestational age at delivery, C-section, and the mother’s psychological state of mind at every assessment time. Only a small proportion of mothers were receiving psychological support at 18 months. Preterm mothers are a population at risk of developing a long-lasting postpartum posttraumatic disorder, therefore immediate and delayed systematic screenings for posttraumatic symptoms are strongly recommended to guide at-risk mothers towards appropriate psychological support.

Highlights

BackgroundOver the past decades, the frequency of premature live births has increased worldwide
The same research team had previously estimated a 9.8% global rate in 2000. This increasing number of preterm live births may be related to the continuing medical progress prior to pregnancy including the development of assisted reproduction technologies (ART), during the pregnancy with obstetric care and during the neonatal period thanks to neonatal intensive care
Our results indicate that 36% of the mothers who delivered before 32 weeks of gestation had an modified Perinatal Posttraumatic stress disorder Questionnaire (mPPQ) score above the threshold indicating that they were currently suffering from significant posttraumatic symptoms 18 months after their preterm delivery

Summary

Introduction

The frequency of premature live births has increased worldwide. The same research team had previously estimated a 9.8% global rate in 2000. This increasing number of preterm live births may be related to the continuing medical progress prior to pregnancy including the development of assisted reproduction technologies (ART), during the pregnancy with obstetric care and during the neonatal period thanks to neonatal intensive care. Several studies demonstrate that ART induced pregnancies are at higher risk of premature delivery, even in singleton pregnancies, compared to the general population [3,4,5]

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