Postpartum post-traumatic stress disorder: Associated perinatal factors and quality of life

J Affect Disord. 2019 Apr 15:249:143-150. doi: 10.1016/j.jad.2019.01.042. Epub 2019 Feb 10.

Abstract

Background: The relationship between obstetric variables and postpartum post-traumatic stress disorder (PTSD), and its influence on quality of life (QoL), have scarcely been studied.

Objective: Determine the prevalence of PTSD at postpartum weeks 4 and 6, and its relation with perinatal variables and quality of life METHOD: A cross-sectional study with 2990 Spanish puerperal women in Spain. Data were collected on socio-demographic and obstetric variables, and on newborns. An online ad hoc questionnaire was used, including the Perinatal Post-traumatic Stress Disorder Questionnaire (PPQ) and SF-36. The crude and adjusted odds ratios were estimated by binary logistic regression.

Results: 10.6% (318) of the women appeared at risk for PTSD symptoms. Factors like having a respected birth plan (aOR: 0.52; 95%CI: 0.34, 0.80), using epidural analgesia (aOR: 0.64; 95%CI: 0.44, 0.92) and performing skin-to-skin contact (aOR: 0.37; 95%CI: 0.28, 0.50) were protective factors against PTSD, among others. Instrumental birth (aOR: 2.50; 95%CI: 1.70, 3.69) and caesarean section (aOR: 3.79; 95%CI: 2.43, 5.92) were found to be risk factors, among others. The area under the ROC curve in this model was 0.79 (95%CI: 0.76, 0.81). The women with PTSD presented a mean difference for QoL of -13.37 points less than those without PTSD (95%CI: -11.08, -15.65).

Conclusions: The women with PTSD symptoms had a worse quality of life at postpartum weeks 4-6. Birth type, analgesia methods and humanising practices, like skin-to-skin contact and using respected birth plans, were related with presence of the postpartum PTSD risk.

Keywords: Associated factors; Perinatal variables; Post-traumatic stress disorder (PTSD); Postpartum; Quality of life.

MeSH terms

  • Adult
  • Cesarean Section
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant, Newborn
  • Logistic Models
  • Odds Ratio
  • Parturition
  • Postpartum Period / psychology*
  • Pregnancy
  • Prenatal Care
  • Prevalence
  • Quality of Life / psychology*
  • Risk Factors
  • Spain
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Surveys and Questionnaires