Risk for trauma-related distress following difficult childbirth: Trajectories of traumatic intrusions across 2 years postpartum.

Abstract

There is heightened risk for maternal posttraumatic stress disorder (PTSD) during the perinatal period. However, it is unclear whether pregnancy and childbirth uniquely contribute to PTSD symptoms above and beyond elevations in negative affectivity that commonly occur among postpartum women (e.g., irritability, fatigue, depressed mood) and past trauma exposure. The present study explored the associations between childbirth stressors and trauma-related distress (TRD; intrusion and avoidance symptoms) across the 2years following childbirth in a community sample of women (n = 159). Maternal TRD was assessed at pregnancy and four additional timepoints across 2years postpartum. At pregnancy, mothers completed surveys measuring exposure to trauma and pregnancy-related anxiety. They also reported on pregnancy and childbirth complications across the first 6months postpartum. Consistent with predictions, labor/delivery complications uniquely predicted increased maternal intrusions during the first 6months postpartum above and beyond past trauma exposure. Furthermore, growth mixture models identified a subset of women with intrusion symptoms that persisted up to 2years postpartum and, on average, exceeded the screening threshold for PTSD. Women who experienced greater labor complications were more likely to exhibit this clinical profile relative to low, stable symptoms. Findings highlight the importance of ongoing screening for TRD across the first 2years postpartum, particularly among women who experience greater labor/delivery complications.