When PTSD Meets Pregnancy

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PTSD and depression during pregnancy increased risk of preterm birth

June 11, 2014 / Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

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(dailyRx News) While PTSD is often associated with the battlefield, anyone can experience it after any traumatic situation. In fact, about one in 12 pregnant women have PTSD symptoms.

A recent study found that having PTSD (post traumatic stress disorder) while pregnant appeared to increase the risk of giving birth early.

The researchers found that women were four times more likely to give birth early if they had PTSD and depression.

This finding was separate from the influence of any medication used to treat the condition.

"Seek treatment for PTSD symptoms."

This study, led by Kimberly Ann Yonkers, MD, aimed to learn whether preterm birth resulted from having PTSD while pregnant and/or from medication to treat the PTSD.

The researchers tracked 2,654 pregnant women in Connecticut and Massachusetts, starting from before their 17th week of pregnancy and through birth to see which babies were born before the 37th week of pregnancy.

The women were also assessed for whether they had symptoms of PTSD and whether they were taking antidepressants (serotonin reuptake inhibitors, or SSRIs) and/or benzodiazepines.

The PTSD symptoms were assessed on a diagnostic scale called the Modified PTSD Symptom Scale. Its scores range from 0 to 51, and a 28 is considered having PTSD.

The researchers found that women with PTSD had higher rates of preterm birth than those without PTSD.

For each additional point a woman scored on the PTSD Symptom Scale, her risk of having a baby early (before the 37th week) increased by 1 to 2 percent.

The rates of preterm birth were highest, however, for those women who had PTSD and major depression.

Women with both PTSD and depression had four times greater odds of having a preterm birth than women without either condition.

Meanwhile, women taking benzodiazepine were twice as likely to have a preterm birth, and women taking SSRI antidepressants were 1.5 times more likely to have a preterm birth, compared to women not taking psychotropic medications.

The researchers therefore concluded that women with PTSD and depression had a risk four times greater for giving birth early, separate from any increased risks for preterm births from medication.

Andre Hall, MD, an OBGYN at Birth and Women's Care, PA in Fayetteville, NC, said that the causes of preterm labor are not well understood, but doctors are aware of risk factors that can increase the likelihood of giving birth early.

"Preterm delivery significantly increases the risks to the newborn and these challenges can be lifelong for the newly born child," Dr. Hall said. "PTSD and other conditions known to increase stress have been associated with preterm labor."

He noted that current events over the past decade may increase the need for doctors to be on the lookout for some of these conditions.

"Given the recent wars and other situations known to increase PTSD, we can expect obstetrical problems to increase, and therefore increased vigilance will be needed to address the psychiatric conditions as they are identified," Dr. Hall said.

This study was published June 11 in the journal JAMA Psychiatry. The research was funded by the National Institute of Child Health and Human Development and the National Institute of Mental Health.

One author has received research support from Pfizer, Johnson and Johnson, Abbott, AbbVie and Merck. Another has received royalties from UpToDate.

Review Date: 
June 11, 2014
Last Updated:
July 1, 2014