Posttraumatic stress disorder 2 months after cesarean delivery: a multicenter prospective study

Area of Science:

• Obstetrics and Gynecology
• Psychiatry
• Perinatal Mental Health

Background:

• Posttraumatic stress disorder (PTSD) following cesarean delivery is not well understood in general populations.
• Identifying prevalence and risk factors is crucial for targeted support.

Purpose of the Study:

• To determine the prevalence of PTSD symptoms at 2 months postpartum in women who underwent cesarean delivery.
• To identify risk factors associated with PTSD after cesarean delivery in a general population.

Main Methods:

• Prospective cohort study nested within the TRAAP2 trial across 27 French hospitals.
• Assessed PTSD using Impact of Event Scale-Revised and Traumatic Event Scale questionnaires at 2 months postpartum.
• Used inverse probability weighting for nonresponse and multivariate logistic/linear regression for risk factor analysis.

Main Results:

• PTSD profile prevalence was 9.0% (95% CI, 7.8%-10.3%); provisional diagnosis was 1.7% (95% CI, 1.2%-2.4%).
• Risk factors included induced labor, postpartum hemorrhage, high postpartum pain, young age, high BMI, and African-born migrant status.
• Immediate skin-to-skin contact was associated with lower PTSD risk; negative delivery memories were associated with higher risk.

Conclusions:

• Nearly 1 in 11 women develop PTSD symptoms after cesarean delivery.
• Specific obstetric interventions and management aspects during cesarean delivery may impact PTSD risk.