Associations between history of trauma and postnatal mental health problems - a cross-sectional study

Pregnancy and childbirth are vulnerable periods for women's mental health, with common occurrences of postnatal depression (PPD), postpartum post-traumatic stress symptoms (PP-PTSS) and postnatal severe fear of childbirth (PP-FOC). While previous trauma is linked to higher rates of postpartum psychological difficulties, the mechanisms and variations by parity and sociodemographic factors remain poorly understood. The aim of this study was to compare the prevalence of PPD symptoms, postnatal post-traumatic stress disorder (PP-PTSD), PP-PTSS and PP-FOC between women with a history of trauma and those without. Additionally, the study aimed to analyse the prevalence of previous trauma and postnatal mental health problems in subgroups of primi- and multiparous women, and to investigate how trauma influenced mental health in relation to sociodemographic characteristics.

This was a cross-sectional study including 619 women who had given birth at five maternity clinics in Sweden. Data for the survey were collected online using validated instruments to measure PPD, PP-PTSD, PP-PTSS and PP-FOC. Data were analysed using Chi-squared tests, independent t-tests and uni- and multivariable regression.

Women with a trauma history (n = 298) showed significantly higher rates of PPD (26% vs. 13%) and PTSD (5% vs. 2%) than those without a trauma history (n = 321). Previous trauma, age and parity significantly influenced postnatal outcomes, with trauma having the most substantial impact.

A history of trauma is correlated to higher risk of postpartum mental health problems, while previous births may offer some protection, especially against PP-PTSS and PP-FOC. Early identification and targeted support for women with trauma histories are recommended.