Exploring posttraumatic stress disorder symptom profile among pregnant women

Abstract

Posttraumatic stress disorder (PTSD) is more prevalent in perinatal than general samples of women (6–8% vs. 4–5%). To explore potential causes, we examined the symptom profiles of women belonging to two separate samples: a perinatal clinic sample (n = 1581) and a subsample of women in a similar age range from the U. S. National Women's Study (NWS) (n = 2000). Within the perinatal sample, risk ratios were higher for all 17 PTSD symptoms among women with current PTSD compared with unaffected women, suggesting that higher rates are not likely due to measurement error. The younger age and greater social disadvantage in the perinatal clinic sample contributed only a small proportion of variance in symptom levels compared with extent of trauma exposure and pre-existing PTSD. Compared with the national study sample's symptom profile, the perinatal sample had higher rates of occurrence of five symptoms: detachment, loss of interest, anger and irritability, trouble sleeping, and nightmares. This analysis confirms that PTSD rates are higher in perinatal samples, which is likely due to exacerbation of pre-existing PTSD among women of a younger age and greater social disadvantage. Further elucidation is warranted, including identifying triggers and determining if there are needs for pregnancy-specific interventions.

Keywords:

• Posttraumatic stress
• trauma exposure
• PTSD symptom profile
• pregnancy
• prevalence

Acknowledgements

The parent projects' funding was provided by the National Institute for Nursing Research (R01 NR008767, Psychobiology of PTSD & Adverse Outcomes of Childbearing) and The NWS was funded by National Institute on Drug Abuse (Grant DA 05220, Risk Factors for Substance Abuse: A Longitudinal Study, Dean G. Kilpatrick, Principal Investigator). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research, the National Institutes of Health, or the National Institute on Drug Abuse. Dr. Rauch's contribution was based upon work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences Research and Development. The authors thank David L. Ronis, PhD and Giupeng Liu, MS, for their assistance with the cross-validation.