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. 2022 Jun 14;22(1):487.
doi: 10.1186/s12884-022-04797-7.

Screening for PTSD during pregnancy: a missed opportunity

Avelina C Padin  1 , Natalie R Stevens  2 , Mandy L Che  3 , Ihuoma N Erondu  3 , Marisa J Perera  2 , Madeleine U Shalowitz  2   3   4
Affiliations

Screening for PTSD during pregnancy: a missed opportunity

Avelina C Padin et al. BMC Pregnancy Childbirth. .

Abstract

Background: Prenatal posttraumatic stress disorder (PTSD) is often overlooked in obstetric care, despite evidence that untreated PTSD negatively impacts both mother and baby. OB-GYN clinics commonly screen for depression in pregnant patients; however, prenatal PTSD screening is rare. Although the lack of PTSD screening likely leaves a significant portion of pregnant patients with unaddressed mental health needs, the size of this care gap has not been previously investigated.

Methods: This retrospective chart review study included data from 1,402 adult, pregnant patients who completed PTSD (PTSD Checklist-2; PCL) and depression (Edinburgh Postnatal Depression Survey; EPDS) screenings during a routine prenatal care visit. Descriptive statistics identified screening rates for PTSD and depression, and logistic regression analyses identified demographic variables associated with screening outcomes and assessed whether screening results (+ PCL/ + EPDS, + PCL/-EPDS, -PCL/ + EPDS, -PCL/-EPDS) were associated with different provider intervention recommendations.

Results: 11.1% of participants screened positive for PTSD alone, 3.8% for depression alone, and 5.4% for both depression and PTSD. Black (OR = 2.24, 95% CI [1.41,3.54]) and Latinx (OR = 1.64, 95% CI [1.01,2.66]) patients were more likely to screen positive for PTSD compared to White patients, while those on public insurance were 1.64 times (95% CI [1.21,2.22]) more likely to screen positive compared to those with private insurance. Patients who screened positive for both depression and PTSD were most likely to receive referrals for behavioral health services (44.6%), followed by -PCL/ + EPDS (32.6%), + PCL/-EPDS (10.5%), and -PCL/-EPDS (3.6%). A similar pattern emerged for psychotropic medication prescriptions.

Conclusions: Over ten percent of pregnant patients in the current study screened positive for PTSD without depression, highlighting a critical mental health need left unaddressed by current obstetric standards of care. Routine PTSD screening during prenatal care alongside strategies aimed at increasing referral resources and access to mental health services are recommended.

Keywords: PTSD; Perinatal; Posttraumatic stress disorder; Pregnancy; Screening; Trauma.

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Conflict of interest statement

The authors declare they have no competing interests.

References

    1. Yildiz PD, Ayers S, Phillips L. The prevalence of posttraumatic stress disorder in pregnancy and after birth: a systematic review and meta-analysis. J Affect Disord. 2017;15(208):634–645. doi: 10.1016/j.jad.2016.10.009. - DOI - PubMed
    1. Shaw JG, Asch SM, Kimerling R, Frayne SM, Shaw KA, Phibbs CS. Posttraumatic stress disorder and risk of spontaneous preterm birth. Obstet Gynecol. 2014;124(6):1111–1119. doi: 10.1097/AOG.0000000000000542. - DOI - PubMed
    1. Shaw JG, Asch SM, Katon JG, Shaw KA, Kimerling R, Frayne SM, et al. Post-traumatic stress disorder and antepartum complications: a novel risk factor for gestational diabetes and preeclampsia. Paediatr Perinat Epidemiol. 2017;31(3):185–194. doi: 10.1111/ppe.12349. - DOI - PubMed
    1. Yonkers KA, Smith MV, Forray A, Epperson CN, Costello D, Lin H, et al. Pregnant women with posttraumatic stress disorder and risk of preterm birth. JAMA Psychiat. 2014;71(8):897–904. doi: 10.1001/jamapsychiatry.2014.558. - DOI - PMC - PubMed
    1. Lev-Wiesel R, Chen R, Daphna-Tekoah S, Hod M. Past traumatic events: are they a risk factor for high-risk pregnancy, delivery complications, and postpartum posttraumatic symptoms? J Womens Health (Larchmt) 2009;18(1):119–125. doi: 10.1089/jwh.2008.0774. - DOI - PubMed