Posttraumatic Stress Disorder and Pregnancy Outcomes in the Military [2F]

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Abstract

INTRODUCTION:

Posttraumatic stress disorder (PTSD) is common in reproductive age women, with an estimated lifetime prevalence of 9.7 to 12.3%. Our goal was to determine the prevalence of PTSD in a pregnant military population and to determine if women with PTSD are at increased risk for adverse pregnancy outcomes.

METHODS:

We conducted a planned interim analysis of an ongoing prospective cohort study. Pregnant patients were screened for PTSD, depression and substance use at 3 points in their pregnancy. Surveys used included the PTSD Checklist, Trauma History Screen, Combat Exposure Scale, Edinburgh Depression Screen and T-ACE. The primary outcomes were preterm delivery and depression.

RESULTS:

A total of 448 women were screened. 14.8% (16) military respondents screened positive for PTSD, and 6 (5.5%) had a presumptive diagnosis of PTSD. 11.1% (38) civilian respondents screened positive for PTSD, and 24 (7%) had a presumptive diagnosis of PTSD. A significant relationship between PTSD and depression exists, χ2 97.5, P=.001, but not for PTSD and preterm delivery, χ2 1.47, P=.226. Adjusting for preterm delivery and depression, the odds of having PTSD was significantly higher for women with depression, aOR 24.9 (95% CI = 8.9–69.7). However the odds of having PTSD was not significantly higher for women who delivered preterm, aOR 3 (95% CI = 0.86–11.52).

CONCLUSION:

In a military population, PTSD is a common problem. There is a significant relationship between PTSD and depression, and obstetric providers should be mindful of PTSD and traumatic events that may contribute to or worsen depression in pregnant women.

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