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A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events

Published online by Cambridge University Press:  11 January 2010

K. L. Alcorn ,
A. O'Donovan ,
J. C. Patrick ,
D. Creedy  and
G. J. Devilly
K. L. Alcorn
Affiliation:
School of Psychology, Griffith University, Queensland, Australia
A. O'Donovan
Affiliation:
School of Psychology, Griffith University, Queensland, Australia
J. C. Patrick
Affiliation:
Department of Psychology, University of Southern Queensland, Queensland, Australia
D. Creedy
Affiliation:
Griffith Health, Griffith University, Queensland, Australia
G. J. Devilly*
Affiliation:
School of Psychology, Griffith University, Queensland, Australia Griffith Institute for Health & Medical Research, Griffith University, Queensland, Australia
*
*Address for correspondence: Dr G. J. Devilly, School of Psychology and Griffith Institute for Health & Medical Research, Griffith University, Mt Gravatt, Qld 4122, Australia. (Email: [email protected]) (Email: [email protected])
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Abstract

Background

Childbirth has been linked to postpartum impairment. However, controversy exists regarding the onset and prevalence of post-traumatic stress disorder (PTSD) after childbirth, with seminal studies being limited by methodological issues. This longitudinal prospective study examined the prevalence of PTSD following childbirth in a large sample while controlling for pre-existing PTSD and affective symptomatology.

Method

Pregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy, 4–6 weeks postpartum, 12 weeks postpartum and 24 weeks postpartum.

Results

Of the 1067 women approached, 933 were recruited into the study. In total, 866 (93%) were retained to 4–6 weeks, 826 (89%) were retained to 12 weeks and 776 (83%) were retained to 24 weeks. Results indicated that, uncontrolled, 3.6% of women met PTSD criteria at 4–6 weeks postpartum, 6.3% at 12 weeks postpartum and 5.8% at 24 weeks postpartum. When controlling for PTSD and partial PTSD due to previous traumatic events as well as clinically significant anxiety and depression during pregnancy, PTSD rates were less at 1.2% at 4–6 weeks, 3.1% at 12 weeks and 3.1% at 24 weeks postpartum.

Conclusions

This is the first study to demonstrate the occurrence of full criteria PTSD resulting from childbirth after controlling for pre-existing PTSD and partial PTSD and clinically significant depression and anxiety in pregnancy. The findings indicate that PTSD can result from a traumatic birth experience, though this is not the normative response.

Keywords

Childbirthprevalencepostnataltrauma
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 11 , November 2010 , pp. 1849 - 1859
Copyright
Copyright © Cambridge University Press 2010

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References

Allen, S (1998). A qualitative analysis of the process, mediating variables and impact of traumatic childbirth. Journal of Reproductive and Infant Psychology 16, 107–131.CrossRefGoogle Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn – text revision. American Psychiatric Association: Washington, DC.Google Scholar
Australian Bureau of Statistics (2004). Births, Australia, No. 3301.0. Australian Bureau of Statistics: Canberra, Australian Capital Territory.Google Scholar
Australian Bureau of Statistics (2007). Household Income and Income Distribution, Australia, 2005–06. Australian Bureau of Statistics: Canberra, ACT.Google Scholar
Ayers, S (2001). Assessing psychopathology in pregnancy and postpartum. Journal of Psychosomatic Obstetrics and Gynecology 22, 91–102.CrossRefGoogle ScholarPubMed
Ayers, S, Pickering, AD (2001). Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth: Issues in Perinatal Care 28, 111–118.CrossRefGoogle ScholarPubMed
Bailham, D, Joseph, S (2003). Post-traumatic stress following childbirth: a review of the emerging literature and directions for research and practice. Psychology, Health and Medicine 8, 159–168.CrossRefGoogle Scholar
Baldwin, S, Williams, D, Houts, A (2004). The creation, expansion, and embodiment of Posttraumatic Stress Disorder: a case study in historical critical psychopathology. Scientific Review of Mental Health Practice 3, 33–52.Google Scholar
Ballard, CG, Stanley, AK, Brockington, IF (1995). Post-traumatic stress disorder (PTSD) after childbirth. British Journal of Psychiatry 166, 525–528.CrossRefGoogle ScholarPubMed
Ballenger, JC, Davidson, J, Lecrubier, Y, Nutt, DJ, Foa, E, Kessler, RC, McFarlane, AC, Shalev, AY, (2000). Consensus statement on posttraumatic stress disorder from the international consensus group on depression and anxiety. Journal of Clinical Psychiatry 61, 60–66.Google Scholar
Beck, C (2004 a). Post-traumatic stress disorder due to childbirth: the aftermath. Nursing Research 53, 216–224.CrossRefGoogle ScholarPubMed
Beck, C (2004 b). Birth trauma: in the eye of the beholder. Nursing Research 53, 28–35.CrossRefGoogle ScholarPubMed
Brown, S, Lumley, J (1998). Maternal health after childbirth: results of an Australian population based survey. British Journal of Obstetrics and Gynaecology 105, 156–161.CrossRefGoogle ScholarPubMed
Centres for Disease Control and Prevention (2006). Births: final data for 2004. National Vital Statistics Reports 55, 1–102.Google Scholar
Cox, JL, Holden, J, Sagovsky, R (1987). Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150, 782–786.CrossRefGoogle ScholarPubMed
Creamer, M, Burgess, P, McFarlane, AC (2001). Post-traumatic stress disorder: findings from the Australian National Survey of Mental Health and Well-being. Psychological Medicine 31, 1237–1247.CrossRefGoogle ScholarPubMed
Creamer, M, McFarlane, AC, Burgess, P (2005). Psychopathology following trauma: the role of subjective experience. Journal of Affective Disorders 86, 175–782.CrossRefGoogle ScholarPubMed
Creedy, DK, Shochet, IM, Horsfall, J (2000). Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth 27, 104–111.CrossRefGoogle ScholarPubMed
Eberhard-Gran, M, Eskild, A, Tambs, K, Opjordsmoen, S, Samuelsen, SO (2001). Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatrica Scandinavica 104, 243–249.CrossRefGoogle ScholarPubMed
Engelhard, IM, van den Hout, MA, Kindt, M (2003). The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: a prospective study. Personality and Individual Differences 35, 381–388.CrossRefGoogle Scholar
Foa, E, Cashman, L, Jaycox, L, Perry, K (1997). The validation of a self-report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychological Assessment 9, 445–451.Google Scholar
Foa, E, Meadows, E (1997). Psychosocial treatments for posttraumatic stress disorder: a critical review. Annual Review of Psychology 48, 449–480.CrossRefGoogle ScholarPubMed
Fones, C (1996). Posttraumatic stress disorder occurring after painful childbirth. Journal of Nervous and Mental Disease 184, 195–196.Google Scholar
Freedman, SA, Gluck, N, Tuval-Mashiach, R, Brandes, D, Peri, T, Shalev, A (2002). Gender differences in responses to traumatic events: a prospective study. Journal of Traumatic Stress 15, 407–413.CrossRefGoogle ScholarPubMed
Greening, L, Stoppelbein, L, Docter, R (2002). The mediating effects of attributional style and event-specific attributions on post-disaster adjustment. Cognitive Therapy and Research 26, 261–274.CrossRefGoogle Scholar
Griffin, MG, Uhlmansiek, MH, Resick, PA, Mechanic, MB (2004). Comparison of the Posttraumatic Stress Disorder Scale versus the Clinician-Administered Posttraumatic Stress Disorder Scale in Domestic Violence Survivors. Journal of Traumatic Stress 17, 497–503.CrossRefGoogle ScholarPubMed
Johnston-Robledo, I, Barnack, J (2004). Psychological issues in childbirth: potential roles for psychotherapists. Women and Therapy 27, 133–150.CrossRefGoogle Scholar
Keogh, E, Ayers, S, Francis, H (2002). Does anxiety sensitivity predict post-traumatic stress symptoms following childbirth? A preliminary report. Cognitive Behaviour Therapy 31, 145–155.CrossRefGoogle Scholar
Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 1048–1060.CrossRefGoogle ScholarPubMed
Laws, P, Hilder, L (2008). Australia's Mothers and Babies 2006. Australian Institute of Health and Welfare: Sydney, NSW.Google Scholar
Long, ME, Elhai, JD, Schweinle, A, Gray, MJ, Grubaugh, AL, Frueh, C (2008). Differences in posttraumatic stress disorder diagnostic rates and symptom severity between criterion A1 and non-criterion A1 stressors. Journal of Anxiety Disorders 22, 1255–1263.CrossRefGoogle ScholarPubMed
McNally, RJ (2003). Progress and controversy in the study of posttraumatic stress disorder. Annual Review of Psychology 54, 229–252.CrossRefGoogle Scholar
Matthey, S (2004). Calculating clinically significant change in postnatal depression studies using the Edinburgh Postnatal Depression Scale. Journal of Affective Disorders 78, 269–272.Google Scholar
Matthey, S, Barnett, B, Howie, P, Kavanagh, DJ (2003). Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? Journal of Affective Disorders 74, 139–147.Google Scholar
Murray, D, Cox, J (1990). Screening for depression during pregnancy with the Edinburgh Depression Scale (EPDS). Journal of Reproductive and Infant Psychology 8, 99–107.Google Scholar
National Statistics Online (2007). UK Office of National Statistics: people and migration – births and deaths (http://www.statistics.gov.uk/cci/nugget.asp?id=761). Accessed 27 November 2007.Google Scholar
Olde, E, van der Hart, O, Kleber, RJ, van Son, MJ, Wijnen, HA, Pop, VJ (2005). Peritraumatic dissociation and emotions as predictors of PTSD symptoms following childbirth. Journal of Trauma and Dissociation 6, 125–142.CrossRefGoogle ScholarPubMed
Righetti-Veltema, M, Conne-Perreard, E, Bousquet, A, Manzano, J (2002). Postpartum depression and mother-infant relationship at 3 months old. Journal of Affective Disorders 70, 291–306.CrossRefGoogle Scholar
Ryding, E, Persson, A, Onell, C, Kvist, L (2003). An evaluation of midwives' counselling of pregnant women in fear of childbirth. Acta Obstetricia et Gynecologica Scandinavica 82, 10–17.Google Scholar
Saisto, T, Salmela-Aro, K, Nurmi, JE, Kononen, T, Halmesmaki, E (2001). A randomized controlled trial of intervention in fear of childbirth. Obstetrics and Gynecology 98, 820–826.Google ScholarPubMed
Sjostrom, K, Valentin, L, Thelin, T, Marsal, K (2002). Maternal anxiety in late pregnancy: effect on fetal movements and fetal heart rate. Early Human Development 67, 87–100.Google Scholar
Social Policy Research Centre (2006). Baseline Demographic Profile 2001. Social Policy Research Centre: Sydney, NSW.Google Scholar
Söderquist, J, Wijma, B, Wijma, K (2006). The longitudinal course of post-traumatic stress after childbirth. Journal of Psychosomatic Obstetrics and Gynaecology 27, 113–119.CrossRefGoogle ScholarPubMed
Soet, JE, Brack, GA, Dilorio, C (2003). Prevalence and predictors of women's experience of psychological trauma during childbirth. Birth 30, 36–46.CrossRefGoogle ScholarPubMed
Sommer, I, Ehlert, U (2004). Adjustment to trauma exposure: prevalence and predictors of posttraumatic stress disorder symptoms in mountain guides. Journal of Psychosomatic Research 57, 329–335.Google Scholar
Spielberger, C, Gorsuch, R, Lushene, R, Vagg, P, Jacobs, G (1983). Manual for the State-Trait Anxiety Inventory (Form Y). Consulting Pscychologists Press, Inc: Palo Alto, CA.Google Scholar
Stein, MB, Walker, JR, Forde, DR (2000). Gender differences in susceptibility to posttraumatic stress disorder. Behaviour Research and Therapy 38, 619–628.CrossRefGoogle ScholarPubMed
Stein, MB, Walker, JR, Hazen, AL, Forde, DR (1997). Full and partial posttraumatic stress disorder: findings from a community survey. American Journal of Psychiatry 154, 1114–1119.Google ScholarPubMed
Switzer, GE, Dew, MA, Thompson, K, Goycoolea, JM, Derricott, T, Mullins, SD (1999). Posttraumatic stress disorder and service utilization among urban mental health center clients. Journal of Traumatic Stress 12, 25–39.CrossRefGoogle ScholarPubMed
van Hooff, M, McFarlane, AC, Baur, J, Abraham, M, Barnes, DJ (2009). The stressor Criterion-A1 and PTSD: a matter of opinion? Journal of Anxiety Disorders 23, 77–86.Google Scholar
Wijma, K, Soderquist, J, Wijma, B (1997). Posttraumatic stress disorder after childbirth: a cross sectional study. Journal of Anxiety Disorders 11, 587–597.CrossRefGoogle ScholarPubMed