Childbirth related PTSD and its association with infant outcome: A systematic review

Sofie Van Sieleghem; Marina Danckaerts; Rob Rieken; Jolanda M E Okkerse; Ellen de Jonge; Wichor M Bramer; Mijke P Lambregtse-van den Berg

doi:10.1016/j.earlhumdev.2022.105667

Childbirth related PTSD and its association with infant outcome: A systematic review

Early Hum Dev. 2022 Nov:174:105667. doi: 10.1016/j.earlhumdev.2022.105667. Epub 2022 Sep 16.

Authors

Sofie Van Sieleghem¹, Marina Danckaerts², Rob Rieken³, Jolanda M E Okkerse³, Ellen de Jonge⁴, Wichor M Bramer⁵, Mijke P Lambregtse-van den Berg⁶

Affiliations

¹ Department of Child and Adolescent Psychiatry, UPC KU Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: vansieleghem.kinderpsychiater@gmail.com.
² Department of Child and Adolescent Psychiatry, UPC KU Leuven, Herestraat 49, 3000 Leuven, Belgium.
³ Department of Child and Adolescent Psychiatry/psychology, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands.
⁴ Department of psychiatry, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands.
⁵ Medical Library, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
⁶ Department of Child and Adolescent Psychiatry/psychology, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands; Department of psychiatry, Erasmus MC - Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands.

PMID: 36152399
DOI: 10.1016/j.earlhumdev.2022.105667

Abstract

Introduction: Maternal postnatal mental health problems may negatively impact child development. Postpartum research has mainly focused on the impact of maternal depression and anxiety due to their high prevalence (13-25 % and 10-18 %, respectively). However, maternal childbirth-related PTSD (CB-PTSD) could be another important risk factor in child development (estimated prevalence: 4.7 %).

Objective: We investigated whether maternal CB-PTSD (symptoms) are associated with a negative mother-child relationship and/or child developmental outcome for children aged 0-5 years. Furthermore, we examined whether maternal trauma-focused therapy can positively impact mother and child outcomes.

Methods: We performed a systematic review by searching three databases (Embase, Medline, PsycInfo). Search terms involved: 'birth or delivery modes', 'PTSD psychological trauma', and 'child development or child behavior'. Two independent reviewers evaluated all eligible papers.

Results: Thirty-five papers (30 samples) were included and qualitatively reported. Results suggest a negative association of maternal CB-PTSD (symptoms) with mother-infant attachment and child behavior. However, confounding factors may explain this association. The evidence on associations with breastfeeding, sleeping, socio-emotional development, and weight gain is insufficient. Research investigating the effect of maternal trauma-focused therapy on a child's outcome is scarce, contradictory, and of low quality.

Conclusion: This systematic review suggests that maternal CB-PTSD may be associated with an increased number of problems in mother-infant attachment and child behavior, but other domains remain scarcely investigated and methodologic issues are present (cross-sectional study design, influence of confounding variables, sample representativeness, diversity in assessment tools). Our results support a multidisciplinary approach to providing early prevention and screening of the maternal mental health state.

Keywords: Mother-child relations; Object attachment; Parturition; Post-traumatic stress disorders; Postpartum period; Problem behavior.

Publication types

Systematic Review
Review

MeSH terms

Cross-Sectional Studies
Female
Humans
Infant
Mother-Child Relations / psychology
Mothers / psychology
Parturition / psychology
Postpartum Period / psychology
Pregnancy
Stress Disorders, Post-Traumatic* / epidemiology
Stress Disorders, Post-Traumatic* / etiology