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

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