Effects of Postpartum PTSD on Maternal Mental Health and Child Socioemotional Development - a Two-year Follow-up Study

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2024 Nov 29

PMID 39614153

Authors

Anna Suarez

Vera Yakupova

Affiliations

Soon will be listed here.

Abstract

Background: Postpartum posttraumatic stress disorder (PP-PTSD) is a prevalent, yet often unrecognized mental health problem, particularly in low- and middle-income countries. Moreover, the long-term effects of PP-PTSD symptoms on maternal well-being and child socioemotional development beyond the first year postpartum remain largely unknown. This study focused on the association between PP-PTSD symptoms within one year after childbirth and maternal depressive symptoms and child behavioral problems two years later.

Methods: Russian women (n = 419) completed the City Birth Trauma Scale and the Edinburgh Postnatal Depression Scale evaluating symptoms of PP-PTSD and postpartum depression (PPD) via a web-based survey. Mothers also filled in the Beck Depression Inventory that assessed their depressive symptoms and the Child Behavior Checklist that assessed child's behavioral problems 2.24 years later.

Results: The regression analysis showed a significant association between PP-PTSD and elevated depressive symptoms 2 years later even after adjustment for PPD (β = 0.19, 95% Confidence Interval 0.11, 0.26, p < 0.01). Children of mothers with higher PP-PTSD symptoms had higher internalizing, externalizing, and total behavioral problems, independent of PPD and concurrent depressive symptoms (β > 0.12, p < 0.01 for all).

Conclusions: Childbirth-related PTSD presents risk for maternal psychological well-being and child socioemotional development beyond comorbidity with maternal depression. Raising awareness about PP-PTSD among families, communities, healthcare providers, and policymakers is essential in order to decrease stigma of childbirth-related distress, particularly, in low- and middle-income countries like Russia, improve support system during the postpartum period, promote mother-infant bonding in affected women, and, thus, prevent long-term consequences of traumatic childbirth for maternal and child mental health outcomes.

Clinical Trial Number: Not applicable.

Citing Articles

Factors influencing childbirth fear among Asian women: a scoping review.

Kalok A, Kamisan Atan I, Sharip S, Safian N, Shah S Front Public Health. 2025; 12:1448940.

PMID: 39877914 PMC: 11772208. DOI: 10.3389/fpubh.2024.1448940.

References

Huffhines L, Coe J, Busuito A, Seifer R, Parade S . Understanding links between maternal perinatal posttraumatic stress symptoms and infant socioemotional and physical health. Infant Ment Health J. 2022; 43(3):474-492. PMC: 9177799. DOI: 10.1002/imhj.21985. View

Kahalon R, Preis H, Benyamini Y . Mother-infant contact after birth can reduce postpartum post-traumatic stress symptoms through a reduction in birth-related fear and guilt. J Psychosom Res. 2022; 154:110716. DOI: 10.1016/j.jpsychores.2022.110716. View

Yakupova V, Suarez A, Kharchenko A . Birth Experience, Postpartum PTSD and Depression before and during the Pandemic of COVID-19 in Russia. Int J Environ Res Public Health. 2022; 19(1). PMC: 8751046. DOI: 10.3390/ijerph19010335. View

Erickson N, Julian M, Muzik M . Perinatal depression, PTSD, and trauma: Impact on mother-infant attachment and interventions to mitigate the transmission of risk. Int Rev Psychiatry. 2019; 31(3):245-263. DOI: 10.1080/09540261.2018.1563529. View

Garthus-Niegel S, Horsch A, Handtke E, von Soest T, Ayers S, Weidner K . The Impact of Postpartum Posttraumatic Stress and Depression Symptoms on Couples' Relationship Satisfaction: A Population-Based Prospective Study. Front Psychol. 2018; 9:1728. PMC: 6157399. DOI: 10.3389/fpsyg.2018.01728. View

Ayers S, Eagle A, Waring H . The effects of childbirth-related post-traumatic stress disorder on women and their relationships: a qualitative study. Psychol Health Med. 2006; 11(4):389-98. DOI: 10.1080/13548500600708409. View

Ertan D, Hingray C, Burlacu E, Sterle A, El-Hage W . Post-traumatic stress disorder following childbirth. BMC Psychiatry. 2021; 21(1):155. PMC: 7962315. DOI: 10.1186/s12888-021-03158-6. View

Ayers S, Wright D, Thornton A . Development of a Measure of Postpartum PTSD: The City Birth Trauma Scale. Front Psychiatry. 2018; 9:409. PMC: 6153962. DOI: 10.3389/fpsyt.2018.00409. View

Delicate A, Ayers S, Easter A, McMullen S . The impact of childbirth-related post-traumatic stress on a couple's relationship: a systematic review and meta-synthesis. J Reprod Infant Psychol. 2018; 36(1):102-115. DOI: 10.1080/02646838.2017.1397270. View

10.

Bosquet Enlow M, Kitts R, Blood E, Bizarro A, Hofmeister M, Wright R . Maternal posttraumatic stress symptoms and infant emotional reactivity and emotion regulation. Infant Behav Dev. 2011; 34(4):487-503. PMC: 3180882. DOI: 10.1016/j.infbeh.2011.07.007. View

11.

Soderquist J, Wijma B, Thorbert G, Wijma K . Risk factors in pregnancy for post-traumatic stress and depression after childbirth. BJOG. 2009; 116(5):672-80. DOI: 10.1111/j.1471-0528.2008.02083.x. View

12.

Korja R, McMahon C . Maternal prenatal mood problems and lower maternal emotional availability associated with lower quality of child's emotional availability and higher negative affect during still-face procedure. Infancy. 2021; 26(6):901-919. DOI: 10.1111/infa.12428. View

13.

Ayers S, Bond R, Bertullies S, Wijma K . The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychol Med. 2016; 46(6):1121-34. DOI: 10.1017/S0033291715002706. View

14.

Horsch A, Garthus-Niegel S, Ayers S, Chandra P, Hartmann K, Vaisbuch E . Childbirth-related posttraumatic stress disorder: definition, risk factors, pathophysiology, diagnosis, prevention, and treatment. Am J Obstet Gynecol. 2024; 230(3S):S1116-S1127. DOI: 10.1016/j.ajog.2023.09.089. View

15.

Kalindi A, Houle B, Smyth B, Chisumpa V . Gender inequities in women's access to maternal health care utilisation in Zambia: a qualitative analysis. BMC Pregnancy Childbirth. 2023; 23(1):755. PMC: 10601225. DOI: 10.1186/s12884-023-06078-3. View

16.

Gottvall K, Waldenstrom U . Does a traumatic birth experience have an impact on future reproduction?. BJOG. 2002; 109(3):254-60. DOI: 10.1111/j.1471-0528.2002.01200.x. View

17.

Copeland A, Korja R, Nolvi S, Rajasilta O, Pulli E, Kumpulainen V . Maternal sensitivity at the age of 8 months associates with local connectivity of the medial prefrontal cortex in children at 5 years of age. Front Neurosci. 2022; 16:920995. PMC: 9520291. DOI: 10.3389/fnins.2022.920995. View

18.

Ayers S, Horsch A, Garthus-Niegel S, Nieuwenhuijze M, Bogaerts A, Hartmann K . Traumatic birth and childbirth-related post-traumatic stress disorder: International expert consensus recommendations for practice, policy, and research. Women Birth. 2023; 37(2):362-367. DOI: 10.1016/j.wombi.2023.11.006. View

19.

Krol K, Grossmann T . Psychological effects of breastfeeding on children and mothers. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018; 61(8):977-985. PMC: 6096620. DOI: 10.1007/s00103-018-2769-0. View

20.

Suarez A, Shraibman L, Yakupova V . Long-Term Effects of Maternal Depression during Postpartum and Early Parenthood Period on Child Socioemotional Development. Children (Basel). 2023; 10(10). PMC: 10605388. DOI: 10.3390/children10101718. View