[Predictors of postpartum post-traumatic stress disorder in primiparous mothers]

Abstract

Objectives: Identify the potential predictors of postpartum post-traumatic stress disorder (PTSD) in primiparous mothers.

Materials and methods: This longitudinal prospective study evaluated the prevalence of obstetric complications and psychiatric disorders (anxiety, depression, psychic dissociation, PTSD, personality) in the immediate postpartum and after 3-6 months.

Results: Among 456 hospitalized primiparous mothers, 314 were recruited and 212 followed-up prospectively. The prevalence of PTSD symptoms was high and stable through the postpartum (12.7% versus 13.6%). Significant risk factors were associated with postpartum PTSD: social isolation, celibacy or divorce (OR=6.6; P<0.02), history of abortion (OR=6.2; P<0.01) or of infertility (OR=10.4; P<0.007), too long subjective length of labour (OR=3.5; P<0.03), mothers' perceptions of obstetric complications (OR=18.5; P<0.003), high anxiety level at the maternity hospital (OR=3.9; P<0.03), PTSD symptoms after childbirth (OR=6.7; P<0.01) and dependent personality disorder (OR=23.2; P<0.001).

Conclusion: Subjective experience of childbirth, history of obstetric complications, social isolation and dependent personality disorder and high level of stress-anxiety after childbirth are significant predictive factors of postpartum PTSD (3-6 months). The early identification of these factors should lead to early therapeutic intervention in the mothers at risk of PTSD.