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Open Access 01-12-2021 | Post Traumatic Stress Disorder | Research article

Prevalence and associated factors of post-traumatic stress disorder (PTSD) among a cohort of Srilankan post-partum mothers: a cross-sectional study

Authors: Wedisha Imal Gankanda, Ileperuma Arachchige Gayani Malsha Perera Gunathilake, Nalaka Lasantha Kahawala, Augustus Keshala Probhodana Ranaweera

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Abstract

Background

Post-Traumatic Stress Disorder (PTSD) usually follows a catastrophic event. However, the experience of child birth can be severe enough to cause PTSD in some women. The aim of this study is to highlight the prevalence of Post Traumatic Stress Disorder among a cohort of postpartum mothers.

Methods

A cross-sectional study was conducted in field clinics of a semi-urban area in Sri Lanka. A pre-tested interviewer administered checklist was used to collect socio-demographic and pregnancy related data. Pre-existing self-administered, validated Sinhalese versions of the Edinburgh Postnatal Depression Scale (EPDS) and PTSD Symptom Scale-Self Report (PSS-SR) were used to assess the presence of Post-Partum Depression (PPD) and PTSD, respectively. Each participant was assessed for PTSD and PPD after one, two and six months following delivery. Scores of PPD > 9 and PSS-SR > 13 were taken as screening positive for the two conditions, respectively.

Results

Two hundred and twenty-five mothers at the end of postpartum one month were recruited for the study. The response rate at their follow-up visits at the second and sixth months were 95 % (n = 214) and 93 % (n = 211). The prevalence of postpartum PTSD was 2.7 % (n = 6), 0.9 % (n = 2) and 0.5 % (n = 1) after one, two and sixth months respectively. Prevalence of postpartum PTSD was 3.6 % over 6 months. Verbal abuse during labour (p = 0.04) and the presence of postpartum depression (P ≤ 0.001) were significantly associated with postpartum PTSD. There were no significant associations between PTSD and gestational age at delivery, index pregnancy being a planned pregnancy, a history of subfertility, family history of psychiatric disorders, intimate partner violence, receiving antenatal counseling, type and mode of delivery, duration of labour, presence of a labour companion, post-partum hemorrhage, manual removal of placenta, negative birth experience, low APGAR score of the baby at delivery, receiving neonatal and maternal intensive care, birth defects, problems with breast feeding or opportunity to discuss with a health care worker.

Conclusions

Prevalence of postpartum PTSD in this community-based study is 3.6 %; which is comparable with the overall global prevalence. PTSD was significantly associated with verbal abuse during labour and postpartum depression.

Peeler S, Stedmon J, Chung M, Skirton H. Women’s experiences of living with postnatal PTSD. Midwifery. 2018;56:70–8.CrossRef

WHO. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines 10th Revision. WHO. Geneva: World Health Organization; 1992.

Post-traumatic stress. disorder: management | Guidance and guidelines | NICE. NICE; 2015.

Garthus-Niegel S, Horsch A, Handtke E, von Soest T, Ayers S, Weidner K, et al. The impact of postpartum posttraumatic stress and depression symptoms on couples’ relationship satisfaction: A population-based prospective study. Front Psychol [Internet]. 2018 Sep 19 [cited 2021 May 31];9(SEP):1728. Available from: www.frontiersin.org.

Gottvall K, Waldenstrom U. Does a traumatic birth experience have an impact on future reproduction? BJOG: An Int J Obstet Gynaecol. 2002;109(3):254–60.CrossRef

Cook N, Ayers S, Horsch A. Maternal posttraumatic stress disorder during the perinatal period and child outcomes: A systematic review. J Affect Disord [Internet]. 2018 Jan 1 [cited 2021 May 31];225:18–31. Available from: https://pubmed.ncbi.nlm.nih.gov/28777972/.

Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychol Med. 2016;46(6):1121–34.CrossRef

IMAJ | The Israel Medicine Association Journal | Volume 14, Number. 6, June 2012 | Postpartum Post-Traumatic Stress Disorder symptoms: The Uninvited Birth Companion. [cited 2021 May 31]; Available from: https://www.ima.org.il/MedicineIMAJ/viewarticle.aspx?aid=147.

Naing L, Winn T, Rusli BN. Practical Issues in Calculating the Sample Size for Prevalence Studies. Arch Orofac Sci. 2006;1:9–14.

10.

Hollifield M, Hewage C, Gunawardena CN, Kodituwakku P, Bopagoda K, Weerarathnege K. Symptoms and coping in Sri Lanka 20–21 months after the 2004 tsunami. Br J Psychiatry [Internet]. 2008 Jan [cited 2016 Jul 8];192(1):39–44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18174508.

11.

Rowel D, Jayawardana P, Fernando N, Association SLM. Validation of the Sinhala translation of Edinburgh Postnatal Depression Scale. Ceylon Med J [Internet]. 2008;53(1):10–3. Available from: http://repository.kln.ac.lk/handle/123456789/1880.

12.

Sin GL, Abdin E, Lee J. The PSS-SR as a screening tool for PTSD. Early Interv Psychiatry [Internet]. 2012 May 1 [cited 2021 May 31];6(2):191–4. Available from: https://onlinelibrary.wiley.com/doi/full/https://doi.org/10.1111/j.1751-7893.2011.00327.x.

13.

Grekin R, O’Hara MW. Prevalence and risk factors of postpartum posttraumatic stress disorder: A meta-analysis. Vol. 34: Clinical Psychology Review. Elsevier Inc.; 2014. pp. 389–401.

14.

Beck CT, Gable RK, Sakala C, Declercq ER. Posttraumatic stress disorder in new mothers: results from a two-stage U.S. national survey. Birth [Internet]. 2011 Sep [cited 2016 Jul 31];38(3):216–27. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21884230.

15.

Henriques T, de Moraes CL, Reichenheim ME, de Azevedo GL, Coutinho ESF, Figueira IL de V. Postpartum posttraumatic stress disorder in a fetal high-risk maternity hospital in the city of Rio de Janeiro, Brazil. Cad saúde pública [Internet]. 2015 Dec [cited 2016 Jul 8];31(12):2523–34. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26872229.

16.

Stramrood CAI, Paarlberg KM. Huis In ’t Veld EMJ, Berger LWAR, Vingerhoets AJJM, Schultz WCMW, et al. Posttraumatic stress following childbirth in homelike- and hospital settings. J Psychosom Obstet Gynaecol [Internet]. 2011 Jun [cited 2016 Jul 8];32(2):88–97. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21557681.

17.

Wijma K, Söderquist JWB. Posttraumatic stress disorder after childbirth: a cross sectional study. J Anxiety Disord [Internet]. 1997;11(6):587–97. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9455721/.

18.

Modarres M, Afrasiabi S, Rahnama P, Montazeri A. Prevalence and risk factors of childbirth-related post-traumatic stress symptoms. BMC Pregnancy Childbirth [Internet]. 2012 [cited 2016 Jul 30];12:88. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22938705.

19.

Adewuya A, Ologun Y, Ibigbami O. Post-traumatic stress disorder after childbirth in Nigerian women: prevalence and risk factors. BJOG An Int J Obstet Gynaecol [Internet]. 2006 Mar [cited 2016 Jul 8];113(3):284–8. Available from: https://doi.org/10.1111/j.1471-0528.2006.00861.x.

Title: Prevalence and associated factors of post-traumatic stress disorder (PTSD) among a cohort of Srilankan post-partum mothers: a cross-sectional study
Authors: Wedisha Imal Gankanda
Ileperuma Arachchige Gayani Malsha Perera Gunathilake
Nalaka Lasantha Kahawala
Augustus Keshala Probhodana Ranaweera
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Post Traumatic Stress Disorder
Mood Disorders
Postpartum Depression
Postpartum Depression
Affective Disorder
Published in: BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-021-04058-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence and associated factors of post-traumatic stress disorder (PTSD) among a cohort of Srilankan post-partum mothers: a cross-sectional study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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