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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.

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



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


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.


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).


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.


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


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