Post-traumatic stress disorder following childbirth: prevalence and associated factors-a prospective cohort study

Abstract

Objective: Traumatic experiences during or after childbirth are subject of intense discussions in mainstream and social media as well as in scientific literature. Aim of this evaluation is to estimate the prevalence of post-traumatic stress disorder (PTSD) following childbirth in postpartum women and to evaluate the influence of maternal, obstetrical and neonatal characteristics on the degree of PTSD symptoms measured by the Impact of Events Scale questionnaire (IES-R).

Methods: In total, 589 women who gave birth in the University Medical Center Mainz, Germany in 2016, participated in a survey within the first days after birth. Of these, 278 also participated 6 months later. All participants received the validated Impact of Events Scale questionnaire (IES-R). The influence of maternal, obstetric and fetal parameters on PTSD score was evaluated.

Results: PTSD overall prevalence was 2.9%. Patients with PTSD had significantly less often personal support during labor (p < 0.001). Maternal age (p < 0.001), parity (p < 0.001), migration background (p < 0.001), mode of delivery (p < 0.001) and assistance during labor (p < 0.001) were parameters significantly influential on the PTSD symptom level measured by the IES-R.

Conclusions: Maternal PTSD prevalence after childbirth seems to be quite rare with 2.9%. Nevertheless, recent findings assume that this prevalence may only represent the "tip of the iceberg". PTSD after childbirth should not be underestimated. As PTSD depends on personal vulnerability and existing risk factors, patients at risk have to be detected before childbirth, which appears to be challenging especially for obstetric and family care professionals.

Keywords: Childbirth; Labor; Mode of delivery; Post-traumatic stress disorder; Vulnerability.

Fig. 1

PTSD score on T1 and T2, overall (IES-R, cutoff > 0)