Women with PTSD Face Higher Pregnancy Risk

The researchers divided mothers with PTSD into those with diagnoses present the year before delivery (active PTSD) and those with earlier diagnoses (historical PTSD). They then identified potential confounders including age, race, military deployment, twins, hypertension, substance use, depression, and results of military sexual trauma screening and estimated adjusted odds ratio (OR) of spontaneous preterm delivery as a function of PTSD status.

The results showed that of the 16,334 births, 3,049 (19%) were to mothers with PTSD diagnoses, of whom 1,921 (12%) had active PTSD. Spontaneous preterm delivery was higher in those with active PTSD (9.2%) than those with historical (8%) or no PTSD (7.4%). The association between PTSD and preterm birth persisted, when adjusting for covariates, only in those with active PTSD. Analyses adjusting for comorbid psychiatric and medical diagnoses revealed the association with active PTSD to be robust. The study was published online on November 6, 2014, in Obstetrics & Gynecology.

“Mothers with active PTSD were significantly more likely to suffer spontaneous preterm birth with an attributable 2 excess preterm births per 100 deliveries. Posttraumatic stress disorder's health effects may extend, through birth outcomes, into the next generation,” concluded senior author Associate Professor of Pediatrics Ciaran Phibbs, PhD, of the Stanford March of Dimes Prematurity Research Center. “Mothers with PTSD should be treated as having high-risk pregnancies.”

PTSD is classified as an anxiety disorder. In the typical case, the individual with PTSD persistently avoids all thoughts, emotions, and discussion of the stressor event, and may experience amnesia for it. However, the event is commonly “relived” through intrusive, recurrent recollections, flashbacks, and nightmares. Persons considered at risk include combat military personnel, victims of natural disasters, concentration camp survivors, and victims of violent crime.

The characteristic symptoms are considered acute if lasting less than three months, and chronic if persisting three months or more, and with delayed onset if the symptoms first occur after six months or some years later.

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