A two-item screening of maternal or infant perceived life threat during childbirth prospectively associated with childbirth-related posttraumatic stress symptoms up to six months postpartum: two observational longitudinal studies

Leah Gilbert; Vania Sandoz; Camille Deforges; Antje Horsch

doi:10.3389/fpsyt.2024.1360189

A two-item screening of maternal or infant perceived life threat during childbirth prospectively associated with childbirth-related posttraumatic stress symptoms up to six months postpartum: two observational longitudinal studies

Front Psychiatry. 2024 Apr 9:15:1360189. doi: 10.3389/fpsyt.2024.1360189. eCollection 2024.

Authors

Leah Gilbert^{1

2}, Vania Sandoz^{3

4}, Camille Deforges⁴, Antje Horsch^{1

4}

Affiliations

¹ Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland.
² Charles Perkins Center, Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Penrith, NSW, Australia.
³ Child Abuse and Neglect Team, Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland.
⁴ Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland.

Abstract

Objective: This study investigated prospective relationships between the perception of threat to one's own life or to that of one's infant during childbirth and maternal childbirth-related posttraumatic stress symptoms (CB-PTSS) and probable childbirth-related posttraumatic stress disorder (CB-PTSD) in a community and a community and an emergency cesarean section (ECS) sample.

Methods: Study samples included 72 mothers from a community sample and 75 mothers after emergency cesarean section. Perceived maternal and infant life threat were assessed at ≤1 week postpartum. Maternal CB-PTSS and probable CB-PTSD were assessed with validated questionnaires up to 6 months postpartum. Covariates were extracted from hospital records. Secondary data analysis with logistic and linear regressions was performed.

Results: Globally, mothers were significantly more likely to perceive their infant's life to be threatened, rather than their own. Both types of perceived threat were prospectively but differentially associated with maternal CB-PTSS and probable CB-PTSD at 4-6 weeks and 6 months postpartum. Statistical significance was set at p<0.05.

Conclusion: The type of perceived threat differently influences maternal CB-PTSS and probable CB-PTSD up to 6 months postpartum. These results may be the basis for the development of a short screening instrument after traumatic childbirth in clinical settings. Future studies need to assess the psychometric properties and acceptability of such a brief screening tool.

Keywords: CB-PTSD; birth trauma; childbirth; emergency caesarean section; perceived infant threat; perceived maternal threat; threat perception.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by a project grant from the Swiss National Science Foundation (AH, grant number 32003B_172982).