title: Predictors of birth-related post-traumatic stress symptoms: secondary analysis of a cohort study.
abstract: This study aimed to identify factors associated with birth-related post-traumatic stress symptoms during the early postnatal period. Secondary analysis was conducted using data from a prospective cohort study of 1824 women who gave birth in one large hospital in England. Post-traumatic stress symptoms were measured by the Impact of Event Scale at 6 to 8 weeks postpartum. Zero-inflated negative binomial regression models were developed for analyses. Results showed that post-traumatic stress symptoms were more frequently observed in black women and in women who had a higher pre-pregnancy BMI compared to those with a lower BMI. Women who have a history of mental illness as well as those who gave birth before arriving at the hospital, underwent an emergency caesarean section or experienced severe maternal morbidity or neonatal complications also showed symptoms. Women's perceived control during labour and birth significantly reduced the effects of some risk factors. A higher level of perceived social support during the postnatal period also reduced the risk of post-traumatic stress symptoms. From the perspective of clinical practice, improving women's sense of control during labour and birth appears to be important, as does providing social support following the birth.
authors.affiliation: Graduate School of Medicine, Kyoto University, 53 Kawara-cho Shogo-in, Sakyo-ku, Kyoto, 606-8507, Japan. furuta.marie.8r@kyoto-u.ac.jp.
authors.forename: Marie
authors.initials: M
authors.lastname: Furuta
authors.affiliation: School of Medicine, King's College London, Women's Health Academic Centre KHP, St. Thomas' Hospital, North Wing, 1 Westminster Bridge Road, London, SE1 7EH, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Sandall
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: Cooper
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK.
authors.forename: Debra
authors.initials: D
authors.lastname: Bick
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000523:psychology / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008016:Life Change Events; D001523:Mental Disorders / Q000453:epidemiology*; D008609:Mental Status Schedule; D020380:Needs Assessment; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D012307:Risk Factors; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control / Q000523:psychology
keywords: Cohort studies; Post-traumatic stress disorders; Postnatal care; Zero-inflated negative binomial regression