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J Womens Health (Larchmt). 2004 Apr;13(3):315-24.

Posttraumatic stress disorder after pregnancy, labor, and delivery.

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Centre for Research in Women's Health, Toronto, Canada.



Other studies of posttraumatic stress disorder (PTSD) after birth did not include questions about prior traumatic life events. This study sought to determine if a difficult birth was associated with symptoms of PTSD as well as considering sociodemographics, history of violence, depression, social support, and traumatic life events.


New mothers were recruited on the postpartum ward of six Toronto-area hospitals (n = 253) and were interviewed by telephone 8-10 weeks postpartum (n = 200). We dichotomized the postpartum stress (PTS) into high PTS (answered "yes" to 3 or more items) or low PTS (answered "yes" to 0-2 items). We calculated the odds ratios between difficult birth, other factors, and the binary PTS variable.


Results of multivariable logistic regression revealed that no factor suggestive of a difficult birth was significantly related to high PTS scores, except having two or more maternal complications (odds ratio [OR] = 4.0, 95% confidence interval [CI] = 1.3-12.8). Other independent predictors of high PTS scores were depression during pregnancy (OR = 18.9, 95% CI = 5.8-62.4), having two or more traumatic life events (OR = 3.2, 95% CI = 1.2-8.3), being Canadian born (OR = 3.2, 95% CI = 1.3-8.1), and having higher household income (lowest income group, OR = 0.1, 95% CI = 0.02-0.5), intermediate income group OR = 0.4, 95% CI = 0.2-0.8).


In this study, postpartum stress symptoms appeared to be related more to stressful life events and depression than to pregnancy, labor, and delivery.

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