Skip to main content

Advertisement

SpringerLink
Log in

Posttraumatic Stress Disorder Following Preeclampsia and PPROM: A Prospective Study With 15 Months Follow-Up

  • Articles
  • Published:
Reproductive Sciences Aims and scope Submit manuscript

Abstract

Objective

A prospective longitudinal evaluation of the prevalence of and risk factors for posttraumatic stress disorder (PTSD) in women with preeclampsia (PE) or preterm premature rupture of membranes (PPROM) compared to uncomplicated pregnancies.

Methods

Participating women completed PTSD and depression questionnaires during pregnancy, 6 weeks, and 15 months postpartum. Data regarding psychiatric history and indices of obstetric care were collected from patient charts.

Results

We included 57 PE, 53 PPROM, and 65 healthy pregnant women, of whom 137 also participated in the 15-month follow-up (PE 70%, PPROM 48%, and controls 95%; P < .001). At 6 weeks postpartum, the prevalence of PTSD, but not depression, following childbirth was significantly higher in patients than in controls (14% vs 3%; P=.023).Ahistory of depression, depressive symptoms during pregnancy, and infant death were significantly associated with symptoms of postpartum PTSD. The maternal condition seems to be of less decisive value, as there was no difference between the prevalence of PTSD after PE and PPROM (11% vs 17%; P=.324). At 15 months postpartum, 11% of women with PE had PTSD, some of which did not have PTSD 6 weeks postpartum. The low response rate in the PPROM group at 15 months postpartum does not allow for definite conclusions.

Conclusion

Pregnancies complicated by PE or PPROM are associated with PTSD in a substantial number of women. Especially women with proven vulnerability for psychological problems are at risk of developing PTSD postpartum, as are women whose children died in the perinatal period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ayers S, Joseph S, Kenzie-McHarg K, Slade P, Wijma K. Post-traumatic stress disorder following childbirth: current issues and recommendations for future research. J Psychosom Obstet Gynecol. 2008;29(4):240–250.

    Article  Google Scholar 

  2. Brockington I. Postpartum psychiatric disorders. Lancet. 2004;363(9405):303–310.

    Article  PubMed  Google Scholar 

  3. Beck CT. Post-traumatic stress disorder due to childbirth: the aftermath. Nurs Res. 2004;53(4):216–224.

    Article  PubMed  Google Scholar 

  4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.4th ed. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  5. Brady KT, Killeen TK, Brewerton T, Lucerini S. Comorbidity of psychiatric disorders and posttraumatic stress disorder. J Clin Psychiatry. 2000;61(suppl 7):22–32.

    PubMed  Google Scholar 

  6. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52(12):1048–1060.

    Article  CAS  PubMed  Google Scholar 

  7. Green BL, Lindy JD, Grace MC. Posttraumatic stress disorder. Toward DSM-IV. J Nerv Ment Dis. 1985;173(7):406–411.

    Article  CAS  PubMed  Google Scholar 

  8. Engelhard IM, van Rij M, Boullart I, et al. Posttraumatic stress disorder after pre-eclampsia: an exploratory study. Gen Hosp Psychiatry. 2002;24(4):260–264.

    Article  PubMed  Google Scholar 

  9. Holditch-Davis D, Bartlett TR, Blickman AL, Miles MS. Posttraumatic stress symptoms in mothers of premature infants. J Obstet Gynecol Neonatal Nurs. 2003;32(2):161–171.

    Article  PubMed  Google Scholar 

  10. Kersting A, Dorsch M, Wesselmann U, et al. Maternal posttraumatic stress response after the birth of a very low-birth-weight infant. J Psychosom Res. 2004;57(5):473–476.

    Article  CAS  PubMed  Google Scholar 

  11. Pierrehumbert B, Nicole A, Muller-Nix C, Forcada-Guex M, Ansermet F. Parental post-traumatic reactions after premature birth: implications for sleeping and eating problems in the infant. Arch Dis Child Fetal Neonatal Ed. 2003;88(5):F400–F404.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Soderquist J, Wijma B, Wijma K. The longitudinal course of post-traumatic stress after childbirth. J Psychosom Obstet Gynecol. 2006;27(2):113–119.

    Article  Google Scholar 

  13. Soderquist J, Wijma B, Thorbert G, Wijma K. Risk factors in pregnancy for post-traumatic stress and depression after childbirth. BJOG. 2009;116(5):672–680.

    Article  CAS  PubMed  Google Scholar 

  14. Ayers S, Pickering AD. Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth. 2001;28(2):111–118.

    Article  CAS  PubMed  Google Scholar 

  15. Alcorn KL, O’Donovan A, Patrick JC, Creedy D, Devilly GJ. A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events. Psychol Med. 2010;40(11):1849–1859.

    Article  CAS  PubMed  Google Scholar 

  16. White T, Matthey S, Boyd K, Barnett B. Postnatal depression and post-traumatic stress after childbirth: prevalence, course and co-occurrence. J Reprod Infant Psychol. 2006;24(2):107–120.

    Article  Google Scholar 

  17. Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull. 2003;129(1):52–73.

    Article  PubMed  Google Scholar 

  18. Brown MA, Lindheimer MD, de Swiet M, van Assche A, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertens Pregnancy. 2001;20(1):IX–XIV.

    Article  CAS  PubMed  Google Scholar 

  19. ACOG Practice Bulletin No 80: Premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol. 2007;109(4):1007–1019.

    Article  Google Scholar 

  20. Cohen J. A power primer. Psychol Bull. 1992;112(1):155–159.

    Article  CAS  PubMed  Google Scholar 

  21. CVZ (College voor Zorgverzekeringen). Verloskundig Vademecum 2003. Diemen, The Netherlands: College voor Zorgverzekeringen; 2003.

    Google Scholar 

  22. Stichting Perinatale Registratie Nederland. Perinatale Zorg in Nederland 2006; p. 94, table 9.1.1. http://www.perinatreg.nl/uploads/150/114/Jaarboek_Perinatale_Zorg_2006.pdf. Accessed August 27, 2008.

  23. Waelput AJM, Hoekstra J. Verloskundige zorg samengevat. Volksgezondheid Toekomst Verkenning, Nationaal Kompas Volksgezondheid. Bilthoven (The Netherlands): RIVM; 2008.

    Google Scholar 

  24. First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV Axis I Disorders. New York, NY: Biometrics Research Department; 1997.

    Google Scholar 

  25. Groenestijn MAC, Akkerhuis GW, Kupka RW, Schneider N, Nolen WA. Gestructureerd Klinisch Interview voor de vaststelling van DSM-IV As I Stoornissen. (Dutch adaptation of the SCID for DSM-IV Axis I Disorders). Lisse: Swets & Zeitlinger B.V; 1999.

    Google Scholar 

  26. Foa EB, Riggs DS, Dancu CV, Rothbaum BO. Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. J Trauma Stress. 1993;6(4):459–473.

    Article  Google Scholar 

  27. Beck AT, Steer RA, Brown GK. Beck Depression Inventory Manual. San Antonio, TX: The Psychological Corporation; 1996.

    Google Scholar 

  28. Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. J Pers Assess. 1996;67(3):588–597.

    Article  CAS  Google Scholar 

  29. Steer RA, Brown GK, Beck AT, Sanderson WC. Mean Beck Depression Inventory-II scores by severity of major depressive episode. Psychol Rep. 2001;88(3 pt 2):1075–1076.

    Article  CAS  PubMed  Google Scholar 

  30. Stramrood CAI, Huis in’t Veld EMJ, van Pampus MG, et al. Measuring posttraumatic stress following childbirth: a critical evaluation of instruments. J Psychosom Obstet Gynecol. 2010;31(1):40–49.

    Article  Google Scholar 

  31. Milgrom J, Gemmill AW, Bilszta JL, et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008;108(1–2):147–157.

    Article  PubMed  Google Scholar 

  32. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106(5):1071–1083.

    Article  PubMed  Google Scholar 

  33. Olde E, van der Hart O, Kleber R, van Son M. Posttraumatic stress following childbirth: a review. Clin Psychol Rev. 2006;26(1):1–16.

    Article  PubMed  Google Scholar 

  34. Soderquist J, Wijma K, Wijma B. Traumatic stress after childbirth: the role of obstetric variables. J Psychosom Obstet Gynecol. 2002;23(1):31–39.

    Article  CAS  Google Scholar 

  35. Engelhard IM, van den Hout MA, Arntz A. Posttraumatic stress disorder after pregnancy loss. Gen Hosp Psychiatry. 2001;23(2):62–66.

    Article  CAS  PubMed  Google Scholar 

  36. Turton P, Hughes P, Evans CD, Fainman D. Incidence, correlates and predictors of posttraumatic stress disorder in the pregnancy after stillbirth. Br J Psychiatry. 2001;178:556–560.

    Article  CAS  PubMed  Google Scholar 

  37. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–786.

    Article  CAS  PubMed  Google Scholar 

  38. Lapp LK, Agbokou C, Peretti CS, Ferreri F. Management of post traumatic stress disorder after childbirth: a review. J Psychosom Obstet Gynecol. 2010;31(3):113–122.

    Article  Google Scholar 

  39. Yarcheski A, Mahon NE, Yarcheski TJ, Hanks MM, Cannella BL. A meta-analytic study of predictors of maternal-fetal attachment. Int J Nurs Stud. 2009;46(5):708–715.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, CB 21, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands

    C. A. I. Stramrood MD, J. G. Aarnoudse MD, PhD, P. P. van den Berg MD, PhD, W. C. M. Weijmar Schultz MD, PhD & M. G. van Pampus MD, PhD

  2. Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands

    I. Wessel PhD

  3. University Center for Psychiatry, Groningen, The Netherlands

    B. Doornbos MD, PhD

Authors
  1. C. A. I. Stramrood MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. Wessel PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Doornbos MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. G. Aarnoudse MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. P. van den Berg MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. W. C. M. Weijmar Schultz MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. G. van Pampus MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. A. I. Stramrood MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stramrood, C.A.I., Wessel, I., Doornbos, B. et al. Posttraumatic Stress Disorder Following Preeclampsia and PPROM: A Prospective Study With 15 Months Follow-Up. Reprod. Sci. 18, 645–653 (2011). https://doi.org/10.1177/1933719110395402

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/1933719110395402

Search

Navigation