Abstract
Our study aimed to assess the prevalence of post-traumatic stress disorder (PTSD) after childbirth one year after vaginal delivery and to identify characteristics of women and deliveries associated with it. Questionnaires were mailed a year after delivery to 1103 women with prospectively collected delivery and postpartum data, including a question on day 2 assessing their experience of childbirth. PTSD was assessed a year later by the Impact of Event and Traumatic Event Scales; 22 women (4.2%, 95%CI 2.7–6.3%) met the PTSD diagnostic criteria and 30 (5.7%; 95%CI 3.9–8.0%) PTSD profile criteria. Factors associated with higher risk of PTSD profile were previous abortion (aOR 3.6, 95%CI 1.4–9.3), previous postpartum hemorrhage (Aor 5.3, 95%CI 1.3–21.4), and postpartum hemoglobin <9 g/dl (aOR 2.7, 95%CI 1.0–7.5). Among 56 women (10.3%) reporting bad childbirth memories at day 2 postpartum, 11 (21.1%) met PTSD diagnosis and 11 (21.1%) PTSD profile criteria a year later, compared with 11 (2.4%) (P < 0.001) and 18 (3.8%) (P < 0.001), respectively, of the 489 (87.7%) women with good memories. PTSD is not rare at one year after vaginal delivery in a low-risk population. A simple question at day 2 post partum may identify women most at risk of PTSD and help determine if early intervention is needed.
Highlights
Psychiatric symptoms after delivery are classically divided into three categories: postpartum blues, postpartum depression, and postpartum psychosis
TRACOR was a randomized controlled trial (RCT) conducted in five hospitals between January 1, 2010, and January 31, 2011; it found that controlled cord traction in the third stage of labor did not affect the incidence of postpartum hemorrhage in low-risk women after a vaginal delivery
We investigated the factors associated with post-traumatic stress disorder (PTSD) profiles and Impact of Event Scale (IES) scores of the potential collinearity of some variables, we built two multivariate models for each outcome including either risk factors for excessive 26 or higher by univariate and multivariate logistic regression analysis
Summary
Psychiatric symptoms after delivery are classically divided into three categories: postpartum blues, postpartum depression, and postpartum psychosis Another psychiatric issue that has drawn increasing attention over the last decade is post-traumatic stress disorder (PTSD), an anxiety disorder[1], after childbirth. Previous research into possible predictors or risk factors for postpartum PTSD has found it to be associated with some characteristics of the woman or her pregnancy (pre-existing psychiatric condition, prior traumatic experiences, anxiety trait, nulliparity, or unplanned pregnancy) and the labor and delivery (preterm delivery, physical pain, emergency cesarean, instrumental delivery, high level of fear for self and/or the baby, loss of control, or low support from partner or staff)[4, 14]. The secondary aim was to identify characteristics of labor and delivery as well as women’s early postnatal experience of childbirth associated with a PTSD profile at one year postpartum
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