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. 2025 Feb 6;2(1):e060.
doi: 10.1097/og9.0000000000000060. eCollection 2025 Feb.

Posttraumatic Stress Disorder and Pregnancy Outcomes

Monica A Lutgendorf  1 , Radhika Tyagi  1 , Sarah Edwards  1 , Shad Deering  1 , Sorana Raiciulescu  1 , Robert B Walton  1 , Jason A Pates  1 , Peter G Napolitano  1 , Nicholas Ieronimakis  1
Affiliations

Posttraumatic Stress Disorder and Pregnancy Outcomes

Monica A Lutgendorf et al. O G Open. .

Abstract

Objective: To evaluate the prevalence and effect of posttraumatic stress disorder (PTSD) on pregnancy outcomes among individuals with military health care.

Methods: This was a prospective cohort study of pregnant individuals receiving care at a military tertiary care center from 2014 to 2018. Participants were screened for PTSD with the PTSD Checklist for civilians and for military service members, as well as for traumatic experiences, combat exposure, risk drinking, and depression. Pregnancy outcomes included preterm birth, fetal growth restriction, preeclampsia, gestational diabetes mellitus, hypertensive disorders of pregnancy, outpatient visits, and neonatal intensive care unit admissions.

Results: Among 1,467 pregnant individuals, 1,145 were retained: 298 (26.0%) military service members and 847 (73.9%) civilian family members. A total of 108 individuals screened positive for PTSD: 21 (7.0%) military service members and 87 (10.3%) civilians. Individuals who screened positive for PTSD had a 17-fold increased likelihood for depression (50.9% vs 5.5%, odds ratio [OR] 17.84, 95% CI, 11.24-28.33), a fivefold increased likelihood for risk of alcohol use (14.8% vs 3.0%, OR 5.64, 95% CI, 2.97-10.69), and a greater number of outpatient visits (median 18 vs 22.5, P=.007). Pregnancy complications were not different between military service members and civilians or those who screened positive for PTSD.

Conclusion: Screening results positive for PTSD are associated with positive screen results for depression and risk of alcohol use during pregnancy, with no differences in outcomes. Although we identified no differences in pregnancy outcomes based on PTSD screening results, comorbidities of traumatic stress such as depression and alcohol use disorder may have long-term consequences on maternal and fetal health. Further research is warranted to understand the effect of behavioral health disorders on pregnancy.

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Figures

Fig. 1.
Fig. 1.. STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) enrollment flowchart depicting the sequence of this study from enrollment of pregnant civilian and military participants. PTSD, posttraumatic stress disorder; PCL, PTSD Checklist; NICU, neonatal intensive care unit.
Fig. 2.
Fig. 2.. Adjusted odds ratios (aOR) of outcomes. GDM, gestational diabetes mellitus; NICU, neonatal intensive care unit; PTSD, posttraumatic stress disorder.
See this image and copyright information in PMC

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