TOPLINE

About 1 in 20 women reported persistent or emerging symptoms of posttraumatic stress 2 months after vaginal delivery, which was linked to personal risk factors, bad memories of childbirth, early anemia, and certain obstetric interventions.

METHODOLOGY

• Researchers conducted an ancillary analysis of the TRAAP randomized trial and tracked the patterns of posttraumatic stress symptoms after vaginal delivery.
• They included adult women planned for a vaginal birth of a single live fetus at or after 35 weeks’ gestation across 15 French hospitals between 2015 and 2016.
• A total of 2344 women rated their symptoms of posttraumatic stress on a 0-88 scale at day 2 and month 2 after delivery. Using a cutoff score of 22, they were classified as asymptomatic or recovered or as having emerging or persistent symptoms.

TAKEAWAY

• At 2 months after delivery, 83.4% of women were asymptomatic, 11.0% had recovered, 2.1% had emerging symptoms, and 3.5% had persistent symptoms of posttraumatic stress.
• Among women with acute posttraumatic stress symptoms on day 2, younger women, those born outside Europe, those with a psychiatric history, those with bad memories of childbirth, and those with hemoglobin levels < 9 g/dL were more likely to have persistent symptoms at 2 months than recover.
• Among women without acute posttraumatic stress symptoms on day 2, those who had prior abortion, labor induction, bad memories of delivery, or severe fatigue on day 2 or were hospitalized during pregnancy had 1.7-3.7 times higher odds of experiencing emerging symptoms.
• Receiving epidural pain relief was associated with lower odds of emerging symptoms.

IN PRACTICE

“[The findings] should alert perinatal professionals to the risk for impaired maternal mental health, even after a near or at term vaginal delivery, thus outside of a context that would be identified as traumatic by obstetrics teams,” the researchers wrote.

SOURCE

The study was led by Alizée Froeliger, MD, PhD, of Université Paris Cité in Paris, France. It was published online on June 26 in the American Journal of Obstetrics and Gynecology.

LIMITATIONS

Women who felt less anxious may have been more likely to enroll in the trial during labor, which may have underestimated the prevalence of posttraumatic stress disorder. Symptoms were assessed by self-report rather than by clinical diagnosis.

DISCLOSURES

The analysis did not receive any funding. The TRAAP trial received support from the French Ministry of Health. Several authors reported serving as lecturers and/or consulting for multiple pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.