Operationalizing psychological trauma in pregnancy: A systematic review

Psychological trauma can affect health and well-being across the lifespan but may be significantly impactful, with intergenerational consequences, during pregnancy. However, there appears to be no uniform agreement on the operationalization of psychological trauma in pregnancy. Such agreement is critical for the translation of research findings into clinical care. The purpose of this article was to provide narrative insight into the characterization of psychological trauma during pregnancy.

A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Literature searches were completed between July 2021 and September 2023 using Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, APA PsycINFO, and Cochrane. Two independent reviewers screened abstracts, relevant full-text articles, and extracted data.

Five hundred seventy-six studies were identified that examined psychological trauma during pregnancy. Most assessments of psychological trauma used differing questionnaire-based approaches (79.7%), with variability in the timing of assessments administered and the type of psychological trauma measured. Only 15.8% of studies examined pregnancy-specific psychological trauma. Finally, just 24% of studies evidenced a comprehensive assessment of psychological trauma, with only 28.8% of studies assessing posttraumatic stress disorder.

Findings indicate significant variability in the conceptualization of psychological trauma during pregnancy. A more comprehensive assessment of psychological trauma beginning in the first trimester and repeated across the prenatal period is needed. Such an approach will be critical to the implementation of trauma-informed care to optimize the health and well-being of pregnant women and other perinatal individuals and their developing child and family. (PsycInfo Database Record (c) 2026 APA, all rights reserved).