Prediction of posttraumatic stress disorder symptomatology after childbirth - A Croatian longitudinal study

Women Birth. 2017 Feb;30(1):e17-e23. doi: 10.1016/j.wombi.2016.06.007. Epub 2016 Jul 12.

Abstract

Background: Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder.

Aim: Using a biopsychosocial model, the primary aim of this study was to identify predictors of posttraumatic stress disorder and its symptomatology following childbirth.

Methods: This observational, longitudinal study included 372 postpartum women. In order to explore biopsychosocial predictors, participants completed several questionnaires 3-5 days after childbirth: the Impact of Events Scale Revised, the Big Five Inventory, The Edinburgh Postnatal Depression Scale, breastfeeding practice and social and demographic factors. Six to nine weeks after childbirth, participants re-completed the questionnaires regarding psychiatric symptomatology and breastfeeding practice.

Findings: Using a multivariate level of analysis, the predictors that increased the likelihood of postpartum posttraumatic stress disorder symptomatology at the first study phase were: emergency caesarean section (odds ratio 2.48; confidence interval 1.13-5.43) and neuroticism personality trait (odds ratio 1.12; confidence interval 1.05-1.20). The predictor that increased the likelihood of posttraumatic stress disorder symptomatology at the second study phase was the baseline Impact of Events Scale Revised score (odds ratio 12.55; confidence interval 4.06-38.81). Predictors that decreased the likelihood of symptomatology at the second study phase were life in a nuclear family (odds ratio 0.27; confidence interval 0.09-0.77) and life in a city (odds ratio 0.29; confidence interval 0.09-0.94).

Conclusion: Biopsychosocial theory is applicable to postpartum psychiatric disorders. In addition to screening for depression amongst postpartum women, there is a need to include other postpartum psychiatric symptomatology screenings in routine practice.

Keywords: Biopsychosocial model; Childbirth experience; Depression; Postpartum posttraumatic stress disorder; Screening.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Anxiety Disorders
  • Croatia / epidemiology
  • Delivery, Obstetric / psychology*
  • Delivery, Obstetric / statistics & numerical data
  • Depression / psychology
  • Depression, Postpartum / diagnosis*
  • Depression, Postpartum / epidemiology
  • Depression, Postpartum / psychology
  • Female
  • Humans
  • Longitudinal Studies
  • Neuroticism
  • Odds Ratio
  • Parturition / psychology*
  • Postpartum Period / psychology
  • Predictive Value of Tests
  • Pregnancy
  • Puerperal Disorders / diagnosis*
  • Puerperal Disorders / epidemiology
  • Risk Factors
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology
  • Surveys and Questionnaires