Association between blood pressure trajectories during pregnancy and childbirth-related post-traumatic stress...

Research on the association between blood pressure changes during pregnancy and childbirth-related post-traumatic stress disorder (CB-PTSD) is scarce. This study aimed to explore the impact of blood pressure trajectories during pregnancy on CB-PTSD symptoms.

This cohort study was conducted from October 2022 to August 2023 in Foshan,China. Eligible women were recruited 2-3 days postpartum, with pregnancy blood pressure data retrospectively retrieved from medical records. The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was used to assess CB-PTSD symptoms 42 days postpartum. A latent class growth model was employed to identify blood pressure trajectories, and logistic regression models were used to estimate the associations between blood pressure trajectories and CB-PTSD symptoms.

Among the 709 women included in the study, 67 (9.4 %) exhibited clinically significant CB-PTSD symptoms within 42 days postpartum. Three distinct systolic blood pressure (SBP) and diastolic blood pressure (DBP) trajectories and two pulse pressure (PP) trajectories were identified. Logistic regression analysis showed that the risk of CB-PTSD symptoms was lower in the high-declining PP group (OR = 0.59, 95 %CI = 0.36-0.97) than the low-increasing PP group. After adjusting for confounders, the medium-slow-increasing SBP group (OR = 0.52, 95 %CI = 0.28-0.94) had a lower risk of CB-PTSD symptoms than the low-fast-increasing SBP group. The high-declining PP group (OR = 0.44, 95 %CI = 0.25-0.79) remained associated with a lower risk of CB-PTSD symptoms than the low-increasing PP group after adjustment.

Different patterns of blood pressure changes during pregnancy are associated with CB-PTSD symptoms, with wider blood pressure fluctuations potentially exerting a greater impact. Future research should explore the underlying biological and psychological mechanisms of these associations.