Patterns and Predictors of Perinatal Posttraumatic Stress Symptoms: A Latent Transition Analysis

Background: Pregnancy is a time of increased risk for intimate partner violence (IPV), yet there is a dearth of prospective research examining the relationship between IPV and posttraumatic stress symptoms (PTSS) in the perinatal period. Further, relationships among different types of IPV and perinatal PTSS remain understudied.

Methods: Latent class and transition analyses were used to examine classes of PTSS in pregnancy and postpartum, the longitudinal patterns of transitions across these classes, and the role of IPV types, childhood adversity, and depressive symptoms in PTSS presentation. Participants (N = 238) were drawn from two longitudinal studies of high-risk perinatal women.

Results: Four latent PTSS classes emerged: High, Avoidant, Hypervigilant, and Low. Childhood adversity (χ(3) = 13.09, p = .004), prenatal depression (χ(3) = 17.58, p = .001), and psychological IPV (χ(3) = 10.51, p = .01) were associated with membership in High, Avoidant, and Hypervigilant classes. Women with low prenatal PTSS continued to have low levels at postpartum. Women in higher severity classes during pregnancy tended to transition into classes with adjacent, and often lower, levels of symptom severity postpartum. Women in the High PTSS class in pregnancy with elevated levels of depression were significantly more likely to remain in the High PTSS class or transition into the Avoidant class at postpartum, compared to the Low PTSS class, χ(3) = 11.84, p = .008.

Limitations: Relatively modest sample size precluded examination of a broader range of symptoms consistent with PTSD.

Conclusions: Findings highlight the importance of individualized approaches to assessing, monitoring, and treating perinatal PTSS.