Prevalence, trauma history, and risk for posttraumatic stress disorder among nulliparous women in maternity care.
OBJECTIVE
To estimate prevalence and assess the association of types of trauma with posttraumatic stress disorder (PTSD) in a sociodemographically and racially mixed sample of women from both predominantly Medicaid and privately insured settings who are expecting their first infant.


METHODS
Structured telephone diagnostic interview data were analyzed for prevalence of trauma exposure, PTSD, comorbidity, risk behaviors, and treatment-seeking among 1,581 diverse English-speaking nulliparous women.


RESULTS
The overall rate of lifetime PTSD was 20.2%, 17% in the predominantly private-payer settings, and 24% in the predominantly public-payer settings. The overall rate of current PTSD was 7.9%, 2.7% in the predominantly private-payer settings and 13.9% in the predominantly public-payer settings. Those with current PTSD were more likely to be African American, pregnant as a teen, living in poverty, with high school education or less, and living in higher-crime areas. Adjusted odds of having current PTSD were highest among those whose worst trauma exposure was abuse (odds ratio 11.9, 95% confidence interval 3.6-39.9), followed by reproductive trauma (odds ratio 6.1, 95% confidence interval 1.5-24.4). Health risk behaviors and exposures were concentrated among those with PTSD.


CONCLUSIONS
These findings affirm that PTSD affects pregnant women. Women with PTSD in pregnancy were more likely to have had exposures to childhood abuse and prior traumatic reproductive event, to have cumulative sociodemographic risk factors, comorbid depression and anxiety, and to have sought mental health treatment in the past. Obstetric risk behaviors occur more in women with PTSD.


METHODS
II.
Seng
Julia S
JS
From the University of Michigan Institute for Research on Women and Gender, School of Nursing, Department of Women's Studies, Department of Obstetrics and Gynecology; University of Michigan School of Nursing, Department of Women's Studies, Department of Obstetrics and Gynecology; University of Michigan Institute for Research on Women and Gender; University of Michigan School of Nursing and Ann Arbor Veterans' Affairs Health System; and University of Michigan Department of Psychiatry, Ann Arbor, Michigan.
Low
Lisa Kane
LK
Sperlich
Mickey
M
Ronis
David L
DL
Liberzon
Israel
I
D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D001741:Black or African American; D001007:Anxiety; D016022:Case-Control Studies; D003863:Depression; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D015146:Midwestern United States / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D055815:Young Adult