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J Affect Disord. 2019 Apr 15;249:143-150. doi: 10.1016/j.jad.2019.01.042. Epub 2019 Feb 10.

Postpartum post-traumatic stress disorder: Associated perinatal factors and quality of life.

Author information

1
Mancha-Centro Hospital, Alcázar de San Juan, Ciudad Real, Spain.
2
Ciudad Real University Hospital, Ciudad Real, C/Cuadras n° 8 Bajo, Ciudad Real, Spain.
3
Nursing Faculty. Albacete, Albacete, Spain.
4
Gutierrez Ortega Hospital, Valdepeñas, Ciudad Real, Spain.
5
Virgen de la Salud Hospital, Toledo, Toledo, Spain.
6
Department of Health Sciencies, University of Jaen, Jaen, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Madrid, Spain.

Abstract

BACKGROUND:

The relationship between obstetric variables and postpartum post-traumatic stress disorder (PTSD), and its influence on quality of life (QoL), have scarcely been studied.

OBJECTIVE:

Determine the prevalence of PTSD at postpartum weeks 4 and 6, and its relation with perinatal variables and quality of life METHOD: A cross-sectional study with 2990 Spanish puerperal women in Spain. Data were collected on socio-demographic and obstetric variables, and on newborns. An online ad hoc questionnaire was used, including the Perinatal Post-traumatic Stress Disorder Questionnaire (PPQ) and SF-36. The crude and adjusted odds ratios were estimated by binary logistic regression.

RESULTS:

10.6% (318) of the women appeared at risk for PTSD symptoms. Factors like having a respected birth plan (aOR: 0.52; 95%CI: 0.34, 0.80), using epidural analgesia (aOR: 0.64; 95%CI: 0.44, 0.92) and performing skin-to-skin contact (aOR: 0.37; 95%CI: 0.28, 0.50) were protective factors against PTSD, among others. Instrumental birth (aOR: 2.50; 95%CI: 1.70, 3.69) and caesarean section (aOR: 3.79; 95%CI: 2.43, 5.92) were found to be risk factors, among others. The area under the ROC curve in this model was 0.79 (95%CI: 0.76, 0.81). The women with PTSD presented a mean difference for QoL of -13.37 points less than those without PTSD (95%CI: -11.08, -15.65).

CONCLUSIONS:

The women with PTSD symptoms had a worse quality of life at postpartum weeks 4-6. Birth type, analgesia methods and humanising practices, like skin-to-skin contact and using respected birth plans, were related with presence of the postpartum PTSD risk.

KEYWORDS:

Associated factors; Perinatal variables; Post-traumatic stress disorder (PTSD); Postpartum; Quality of life

PMID:
30772741
DOI:
10.1016/j.jad.2019.01.042

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