Posttraumatic stress disorder after pregnancy, labor, and delivery.

OBJECTIVES: Other studies of posttraumatic stress disorder (PTSD) after birth did not include questions about prior traumatic life events. This study sought to determine if a difficult birth was associated with symptoms of PTSD as well as considering sociodemographics, history of violence, depression, social support, and traumatic life events.

METHODS: New mothers were recruited on the postpartum ward of six Toronto-area hospitals (n = 253) and were interviewed by telephone 8-10 weeks postpartum (n = 200). We dichotomized the postpartum stress (PTS) into high PTS (answered "yes" to 3 or more items) or low PTS (answered "yes" to 0-2 items). We calculated the odds ratios between difficult birth, other factors, and the binary PTS variable.

RESULTS: Results of multivariable logistic regression revealed that no factor suggestive of a difficult birth was significantly related to high PTS scores, except having two or more maternal complications (odds ratio [OR] = 4.0, 95% confidence interval [CI] = 1.3-12.8). Other independent predictors of high PTS scores were depression during pregnancy (OR = 18.9, 95% CI = 5.8-62.4), having two or more traumatic life events (OR = 3.2, 95% CI = 1.2-8.3), being Canadian born (OR = 3.2, 95% CI = 1.3-8.1), and having higher household income (lowest income group, OR = 0.1, 95% CI = 0.02-0.5), intermediate income group OR = 0.4, 95% CI = 0.2-0.8).

CONCLUSIONS: In this study, postpartum stress symptoms appeared to be related more to stressful life events and depression than to pregnancy, labor, and delivery.