Perinatal factors related to post-traumatic stress disorder symptoms 1–5 years following birth

• Published in: Women and birth : journal of the Australian College of Midwives 2020-03, Vol.33 (2), p.e129-e135
• Main Authors: Hernández-Martínez, Antonio, Rodríguez-Almagro, Julian, Molina-Alarcón, Milagros, Infante-Torres, Nuria, Rubio-Álvarez, Ana, Martínez-Galiano, Juan Miguel
• Format: Article
• Language: English
• Subjects: Mode of birth; Nursing; Perinatal; Postpartum; Skin-to-Skin contact; Traumatic stress symptoms
• ISSN: 1871-5192; 1878-1799
• DOI: 10.1016/j.wombi.2019.03.008

The relationship between perinatal variables and post-traumatic stress disorder (PTSD) symptoms was studied. However, the role of some variables in PTSD symptoms is unclear. Determine the prevalence of PTSD symptoms after 1 year postpartum and their relationship with perinatal variables. A cross-sectional study with 1531 puerperal women in Spain. Data were collected on socio-demographic variables, perinatal variables (maternal characteristics, procedures during labour and birth, birth outcomes and time since birth) and the newborn. An online questionnaire was used, which included the Perinatal Post-traumatic Stress Questionnaire (PPQ). Crude and adjusted odds ratios (OR) were calculated using binary logistic regression. 7.2% (110) of the women were identified as being at risk for probable PTSD symptoms. Protective factors were having a birth plan respected (aOR 0.44; 95%CI 0.19−0.99), use of epidural analgesia (aOR 0.44; 95%CI 0.24−0.80) and experiencing skin-to-skin contact (aOR 0.33; 95%CI 0.20−0.55). Risk factors were instrumental birth (aOR 3.32; 95%CI1.73−3.39), caesarean section (aOR 4.80; 95%CI 2.51–9.15), receiving fundal pressure (aOR 1.72; 95%CI 1.08–2.74) and suffering a third/fourth degree perineal tear (aOR 2.73; 95%CI 1.27–5.86). The area under the model’s ROC curve was 0.82 (95%CI 0.79−0.83). Women who experience a normal birth, are psychologically prepared for birth (for example, through use of a birth plan), experience skin-to-skin contact with their newborn, and had a sense of physical control through the use of epidural analgesia, are less likely to experience childbirth as traumatic.