Perinatal factors related to post-traumatic stress disorder symptoms 1-5 years following birth

Background: The relationship between perinatal variables and post-traumatic stress disorder (PTSD) symptoms was studied. However, the role of some variables in PTSD symptoms is unclear. Aim: Determine the prevalence of PTSD symptoms after 1 year postpartum and their relationship with perinatal variables. Methods: A cross-sectional study with 1531 puerperal women in Spain. Data were collected on sociodemographic variables, perinatal variables (maternal characteristics, procedures during labour and birth, birth outcomes and time since birth) and the newborn. An online questionnaire was used, which included the Perinatal Post-traumatic Stress Questionnaire (PPQ). Crude and adjusted odds ratios (OR) were calculated using binary logistic regression. Findings: 7.2% (110) of the women were identified as being at risk for probable PTSD symptoms. Protective factorswere having a birth plan respected (aOR 0.44; 95%CI 0.19-0.99), use of epiduralanalgesia (aOR 0.44; 95%CI 0.24-0.80) and experiencing skin-to-skin contact (aOR 0.33; 95%CI 0.20-0.55). Risk factors were instrumental birth (aOR 3.32; 95%CI1.73-3.39), caesarean section (aOR 4.80; 95%CI 2.51-9.15), receiving fundal pressure (aOR 1.72; 95%CI 1.08-2.74) and suffering a third/fourth degree perineal tear (aOR 2.73; 95%CI 1.27-5.86). The area under the model's ROC curve was 0.82 (95%CI 0.79-0.83). Conclusions: Women who experience a normal birth, are psychologically prepared for birth (for example, through use of a birth plan), experience skin-to-skin contact with their newborn, and had a sense of physical control through the use of epidural analgesia, are less likely to experience childbirth as traumatic. (C) 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.