@article{ref1,
title="Longitudinal trajectories of post-traumatic stress disorder (PTSD) after birth and associated risk factors",
journal="Journal of affective disorders",
year="2018",
author="Dikmen-Yildiz, Pelin and Ayers, Susan and Phillips, Louise",
volume="229",
number="",
pages="377-385",
abstract="BACKGROUND: Although longitudinal trajectories of post-traumatic stress disorder (PTSD) are well-established in general trauma populations, very little is known about the trajectories of birth-related PTSD. This study aimed to identify trajectories of birth-related PTSD; determine factors associated with each trajectory; and identify women more likely to develop birth-related PTSD. <br><br>METHOD: 226 women who had traumatic childbirth according to DSM-IV criterion A were drawn from a community sample of 950 women. Measures were taken of PTSD, affective symptoms, fear of childbirth and social support in pregnancy, 4-6 weeks and 6-months postpartum. Information on some obstetric and psychosocial factors were also prospectively obtained. <br><br>RESULTS: Four trajectories were identified: resilience (61.9%), recovery (18.5%), chronic-PTSD (13.7%) and delayed-PTSD (5.8%). Resilience was consistently distinguished from other PTSD trajectories by less affective symptoms at 4-6 weeks postpartum. Poor satisfaction with health professionals was associated with chronic-PTSD and delayed-PTSD. When affective symptoms at 4-6 weeks postpartum were removed from the model, less social support and higher fear of childbirth 4-6 weeks after birth predicted chronic and recovery trajectories; whereas experience of further trauma and low levels of satisfaction with health professionals were predictive of chronic-PTSD and delayed-PTSD, compared to resilience. Additional variables associated with different trajectories included antenatal affective symptoms, caesarean-section, preterm birth and receiving professional help. LIMITATIONS: Use of self-report measures, use of DSM-IV criteria for PTSD diagnosis, and no follow-up beyond six months are the main limitations of this study. <br><br>CONCLUSION: Identified factors may inform preventive and treatment interventions for women with traumatic birth experiences.<br><br>Copyright © 2018 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2017.12.074",
url="http://dx.doi.org/10.1016/j.jad.2017.12.074"
}