Abstract
Objective
To review the extant literature on the effect of traumatic experiences that pre-date
conception, pregnancy, and the postpartum period (perinatal period) and present a
thematic overview of current issues in this relatively new area of inquiry.
Data Sources
Electronic databases Cochrane, CINAHL, PsychINFO, and PubMed were searched. Manual
searches of reference lists supplemented the electronic search.
Study Selection
Peer-reviewed articles written in English on the role of posttraumatic stress disorder
during the perinatal period were included.
Data Extraction
Key findings relevant to perinatal posttraumatic stress that were reported in primary
sources and meta-analyses were organized according to themes, including The Role of Childbirth, Comorbidity With Depression and Anxiety, Risk Factors for
Perinatal PTSD, High-Risk Health Behaviors, and Association With Adverse Health Outcomes.
Data Synthesis
Across studies, antenatal posttraumatic stress disorder (PTSD) rates were estimated
between 2.3% and 24%, and observed prevalence rates during the postnatal period ranged
from 1% to 20%; however, many researchers failed to assess PTSD that existed before
or during pregnancy, and when preexisting PTSD is a controlled variable, postpartum
rates drop to 2% to 4.7%. In addition to prenatal depression and anxiety and pre-pregnancy
history of psychiatric disorders, history of sexual trauma, childhood sexual abuse,
intimate partner violence, and psychosocial attributes are risk factors for development
or exacerbation of perinatal PTSD.
Conclusion
Women's health care providers should evaluate for PTSD in routine mental health assessments
during and after pregnancy, especially with a reported history of trauma or the presence
of a mood or anxiety disorder. Such screening will allow women to receive needed treatment
and referrals and mitigate the potentially negative sequelae of PTSD. Future investigators
must recognize the importance of subsyndromal posttraumatic stress symptoms and individual
differences in responses to trauma.
Keywords
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Biography
Pamela A. Geller, PhD, is an associate professor in the Department of Psychology, Drexel University; a research associate professor in the Department of Obstetrics and Gynecology, Drexel University College of Medicine; and a Co-Founder and Co-Director of Mother Baby Connections, Drexel University, Philadelphia, PA.
Biography
Emily C. Stasko, MS, MPH, is a PhD candidate at Drexel University, Philadelphia, PA.
Article Info
Publication History
Published online: June 28, 2017
Accepted:
April 2017
Footnotes
The authors report no conflict of interest or relevant financial relationships.
Identification
Copyright
© 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.
