Operationalizing psychological trauma in pregnancy: A systematic review

Area of Science:

• Perinatal mental health
• Trauma studies
• Psychological assessment

Background:

• Psychological trauma during pregnancy has significant health and intergenerational impacts.
• Lack of uniform operationalization of psychological trauma in pregnancy hinders clinical application.
• Standardized assessment is critical for translating research into effective clinical practice.

Purpose of the Study:

• To provide narrative insight into the characterization of psychological trauma during pregnancy.
• To highlight the need for consistent methodologies in assessing trauma in pregnant individuals.

Main Methods:

• Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Comprehensive literature search across multiple databases (MEDLINE, Embase, Scopus, Web of Science, PsycINFO, Cochrane) from July 2021 to September 2023.
• Dual independent reviewer screening of abstracts, full-text articles, and data extraction.

Main Results:

• 576 studies examined psychological trauma in pregnancy, revealing significant methodological heterogeneity.
• Most assessments (79.7%) used varied questionnaire-based approaches, differing in timing and trauma type.
• Few studies (15.8%) focused on pregnancy-specific trauma, and only 24% offered comprehensive assessment; posttraumatic stress disorder was assessed in 28.8%.

Conclusions:

• Substantial variability exists in how psychological trauma during pregnancy is conceptualized and assessed.
• A need exists for comprehensive, trimester-specific, and repeated assessments of psychological trauma.
• Implementing standardized assessments is vital for trauma-informed care, optimizing maternal and child well-being.