Screening for PTSD during pregnancy: a missed opportunity

Area of Science:

• Obstetrics and Gynecology
• Mental Health
• Public Health

Background:

• Prenatal posttraumatic stress disorder (PTSD) is a significant concern impacting maternal and infant well-being, yet it is often overlooked in routine obstetric care.
• While depression screening is common in OB-GYN clinics, prenatal PTSD screening is rare, leaving a substantial gap in mental healthcare for pregnant individuals.
• The prevalence and impact of this care gap have not been thoroughly investigated previously.

Purpose of the Study:

• To investigate the prevalence of prenatal posttraumatic stress disorder (PTSD) and depression among pregnant patients.
• To determine the association between screening results for PTSD and depression and subsequent provider intervention recommendations.
• To identify demographic factors associated with positive PTSD screening in pregnant patients.

Main Methods:

• A retrospective chart review was conducted on 1,402 adult pregnant patients undergoing routine prenatal care.
• Patients completed screenings for PTSD (PTSD Checklist-2; PCL) and depression (Edinburgh Postnatal Depression Survey; EPDS).
• Descriptive statistics and logistic regression analyses were used to examine screening rates, demographic associations, and intervention patterns.

Main Results:

• 11.1% of participants screened positive for PTSD alone, 3.8% for depression alone, and 5.4% for both conditions.
• Black and Latinx patients, as well as those with public insurance, were more likely to screen positive for PTSD.
• Patients with co-occurring PTSD and depression received the most behavioral health referrals, indicating a disparity in intervention based on screening outcomes.

Conclusions:

• Over 10% of pregnant patients screened positive for PTSD without concurrent depression, revealing an unaddressed mental health need in standard obstetric care.
• Routine screening for PTSD during prenatal visits is recommended to identify and address this critical mental health issue.
• Enhancing referral resources and access to mental health services is essential to support pregnant individuals with PTSD.