title: Hypertensive disorders of pregnancy and risk of screening positive for Posttraumatic Stress Disorder: A cross-sectional study.
abstract: OBJECTIVE
  Hypertensive Disorders of Pregnancy (HDP) encompass a spectrum of disorders that affect 6-8% of US pregnancies. We aim to determine the impact of self-reported history of HDP as a risk factor for screening positive for Posttraumatic Stress Disorder (PTSD), which results from exposure to a traumatic event, and to evaluate whether the risk of PTSD differed by severity of HDP.
  
  
  METHODS
  We conducted an online survey on the Preeclampsia Foundation website that is accessed worldwide by women who have experienced HDP, as well as their friends and family. 1448 women in total responded to the survey, including 1076 women who reported a history of HDP in at least one prior pregnancy and 372 women who reported no history of HDP during any prior pregnancy.
  
  
  METHODS
  We measured PTSD outcome with the Breslau Short Screening Scale for DSM-IV PTSD. We used logistic regression to model the relationship between PTSD and HDP.
  
  
  RESULTS
  Women who reported a history of HDP were more than four times as likely to screen positive for PTSD than women who reported having a normotensive pregnancy history (ORadj=4.46, 95% CI: 3.20-6.20). In addition, there was a marked trend toward increasing risk of screening positive for PTSD as the severity of HDP increased from gestational hypertension to eclampsia (p<0.001).
  
  
  CONCLUSIONS
  Women with a history of HDP may be at increased risk of PTSD, with severe cases most likely to suffer from symptoms. Clinicians should consider implementing routine screenings during post-partum visits in this vulnerable population.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2020 Zonal Ave., IRD #211, Los Angeles, CA 90033, United States. Electronic address: jackieporcel@gmail.com.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Porcel
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2020 Zonal Ave., IRD #211, Los Angeles, CA 90033, United States. Electronic address: feigal@usc.edu.
authors.forename: Christine
authors.initials: C
authors.lastname: Feigal
authors.affiliation: Preeclampsia Foundation, 6767 N. Wickham Rd #400, Melbourne, FL 32940, United States. Electronic address: laney.poye@preeclampsia.org.
authors.forename: Laney
authors.initials: L
authors.lastname: Poye
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30001, CB21, 9700 RB Groningen, The Netherlands. Electronic address: i.r.postma@umcg.nl.
authors.forename: Ineke R
authors.initials: IR
authors.lastname: Postma
authors.affiliation: Department of Obstetrics & Gynecology, Division of Obstetrics & Prenatal Medicine, Erasmus MC - Sophia, Room Sk-4130, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: g.g.zeeman@umcg.nl.
authors.forename: Gerda G
authors.initials: GG
authors.lastname: Zeeman
authors.affiliation: Children's Hospital Los Angeles, 4650 W Sunset Ave #94, Los Angeles, CA 90027, United States. Electronic address: aolowoyeye@chla.usc.edu.
authors.forename: Abiola
authors.initials: A
authors.lastname: Olowoyeye
authors.affiliation: Preeclampsia Foundation, 6767 N. Wickham Rd #400, Melbourne, FL 32940, United States. Electronic address: eleni.tsigas@preeclampsia.org.
authors.forename: Eleni
authors.initials: E
authors.lastname: Tsigas
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2020 Zonal Ave., IRD #211, Los Angeles, CA 90033, United States. Electronic address: melisslw@usc.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Wilson
keywords: Eclampsia; Gestational hypertension; HELLP; Posttraumatic stress disorder; Preeclampsia; Severity; Syndrome