PTSD SYMPTOMS ACROSS PREGNANCY AND EARLY POSTPARTUM AMONG WOMEN WITH LIFETIME PTSD DIAGNOSIS

被引:73
|
作者
Muzik, Maria [1 ]
McGinnis, Ellen W. [1 ]
Bocknek, Erika [2 ]
Morelen, Diana [1 ]
Rosenblum, Katherine L. [1 ]
Liberzon, Israel [1 ]
Seng, Julia [1 ,3 ]
Abelson, James L. [1 ]
机构
[1] Univ Michigan, Dept Psychiat, 4250 Plymouth Rd Room 2736, Ann Arbor, MI 48109 USA
[2] Wayne State Univ, Dept Educ, Detroit, MI USA
[3] Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA
关键词
PTSD; trauma; pregnancy and postpartum; depression; maternal child; POSTTRAUMATIC-STRESS-DISORDER; DEPRESSION SCREENING SCALE; MENTAL-HEALTH; TRAUMA EXPOSURE; BIRTH-WEIGHT; MISSING DATA; ABUSE; PREVALENCE; SAMPLE; RISK;
D O I
10.1002/da.22465
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background: Little is known about trajectories of PTSD symptoms across the peripartum period in women with trauma histories, specifically those who met lifetime PTSD diagnoses prior to pregnancy. The present study seeks to identify factors that influence PTSD symptom load across pregnancy and early postpartum, and study its impact on postpartum adaptation. Method: The current study is a secondary analysis on pregnant women with a Lifetime PTSD diagnosis (N = 319) derived from a larger community sample who were interviewed twice across pregnancy (28 and 35 weeks) and again at 6 weeks postpartum, assessing socioeconomic risks, mental health, past and ongoing trauma exposure, and adaptation to postpartum. Results: Using trajectory analysis, first we examined the natural course of PTSD symptoms based on patterns across peripartum, and found four distinct trajectory groups. Second, we explored factors (demographic, historical, and gestational) that shape the PTSD symptom trajectories, and examined the impact of trajectory membership on maternal postpartum adaptation. We found that child abuse history, demographic risk, and lifetime PTSD symptom count increased pregnancy-onset PTSD risk, whereas gestational PTSD symptom trajectory was best predicted by interim trauma and labor anxiety. Women with the greatest PTSD symptom rise during pregnancy were most likely to suffer postpartum depression and reported greatest bonding impairment with their infants at 6 weeks postpartum. Conclusions: Screening for modifiable risks (interpersonal trauma exposure and labor anxiety) and /or PTSD symptom load during pregnancy appears critical to promote maternal wellbeing. (C) 2016 Wiley Periodicals,
引用
收藏
页码:584 / 591
页数:8
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