Posttraumatic stress disorder in pregnancy: prevalence, risk factors, and treatment.
OBJECTIVE
To estimate the prevalence of posttraumatic stress disorder and its treatment in economically disadvantaged pregnant women.


METHODS
The sample included 744 pregnant Medicaid-eligible women from Women, Infants and Children Supplemental Nutrition Program sites in 5 counties in rural Missouri and the city of St. Louis. Race (black and white) was proportional to clients seen at each site. Women were assessed by using standardized measures of posttraumatic stress disorder, 18 other psychiatric disorders, environmental stressors, and pregnancy characteristics. Logistic regression identified risk factors associated with posttraumatic stress disorder.


RESULTS
Posttraumatic stress disorder prevalence was 7.7% (n = 57/744). Comorbid disorders were common. Women with posttraumatic stress disorder were 5 times more likely to have a major depressive episode (odds ratio 5.17; 95% confidence interval 2.61, 10.26) and more than 3 times as likely to have generalized anxiety disorder (odds ratio 3.25; 95% confidence interval 1.22, 8.62). Besides these comorbid disorders, risk factors for posttraumatic stress disorder included a history of maternal separation for 6 months and multiple traumatic events. Although most women with posttraumatic stress disorder reported moderate impairment in their daily lives, only 7 of the 57 women with this disorder reported speaking with any health professional about it in the last 12 months.


CONCLUSIONS
The prevalence of posttraumatic stress disorder in pregnancy and low treatment rates suggest that screening for this disorder should be considered in clinical practice.


METHODS
II-2
Loveland Cook
Cynthia A
CA
Saint Louis University, School of Social Service, St Louis, Missouri 63103, USA. cookca@slu.edu
Flick
Louise H
LH
Homan
Sharon M
SM
Campbell
Claudia
C
McSweeney
Maryellen
M
Gallagher
Mary Elizabeth
ME
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008923:Missouri / Q000453:epidemiology; D011203:Poverty / Q000523:psychology* / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy