Post-traumatic stress disorder in an antenatal population in South Africa: Prevalence and associated factors

The prevalence of post-traumatic stress disorder (PTSD) is uncertain globally, and there is a paucity of information in South Africa. Perinatal PTSD may impair maternal functioning and negatively affect their parenting ability.

This study aimed to determine the prevalence and associated factors of PTSD in an antenatal population in South Africa.

The study was conducted at Johan Heyns Community Health Centre in Sedibeng district, Gauteng province.

A cross-sectional questionnaire-based survey was conducted in which the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5) was administered among women attending the Johan Heyns antenatal clinic. The PCL-5 is a validated screening tool for PTSD, which comprises 20 items scored on a 5-point Likert scale for symptom severity. A total score ≥ 31 indicates at least moderate PTSD.

Of the 98 pregnant women who participated in the study, 53 (54%) reported having experienced or witnessed a traumatic event. Total PCL-50 scores ranged from 0-65 (mean 13.8 standard deviation [s.d. = 18.1]), with at least one intrusion symptom endorsed by 37 women, followed by cognition and mood change by 36, arousal and reactivity by 32, and avoidance by 24. Sixteen women (16.3%) screened positive for PTSD (mean score 49.2 [s.d. = 12.7]). While univariate analysis found no significant associations with PTSD, alcohol use was associated with an increased risk of PTSD on multivariate analysis (RR 2.7; [95% confidence interval [CI] 1.1-7.0; p = 0.036).

Post-traumatic stress disorder is common among antenatal women in Sedibeng district and may be associated with alcohol use in pregnancy.

This study highlights the importance of screening pregnant women for PTSD to ensure early intervention and management.