Risk factors for postpartum posttraumatic stress disorder after emergency admission

doi:10.5847/wjem.j.1920-8642.2024.013

Abstract

Abstract:

BACKGROUND: Postpartum posttraumatic stress disorder (PTSD) can occur in women who give birth after emergency admission. The identification of risk factors for this condition is crucial for developing effective preventive measures. This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.

METHODS: Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023. The patients’ general conditions and perinatal clinical indicators were recorded. The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum. Multivariate logistic regression analysis was performed to identify risk factors.

RESULTS: A total of 276 puerperae were included, with a PTSD incidence of 20.3% at six weeks postpartum. Multivariate logistic regression analysis identified emergency cesarean section (odds ratio [OR]=2.102; 95% confidence interval [CI]: 1.114-3.966, P=0.022), admission to the emergency department after midnight (12:00 AM) (OR=2.245; 95%CI: 1.170-4.305, P<0.001), and cervical dilation (OR=3.203; 95%CI 1.670-6.141, P=0.039) as independent risk factors for postpartum PTSD. Analgesia pump use (OR= 0.500; 95%CI 0.259-0.966, P=0.015) was found to be a protective factor against postpartum PTSD.

CONCLUSION: Emergency cesarean section, admission to the emergency department after midnight, and cervical dilation were identified as independent risk factors for postpartum PTSD, while analgesic pump use was a protective factor. These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.

Key words: Risk factors, Posttraumatic stress disorder, Emergency, Delivery

Fengxia Du, Jun Zha, Yan Li, Lichao Fang, Shuyu Xia, Youjia Yu. Risk factors for postpartum posttraumatic stress disorder after emergency admission[J]. World Journal of Emergency Medicine, 2024, 15(2): 121-125.

Figures/Tables 3

Table 1.

Table 2.

Table 3.

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Risk factors	PTSD patients (n=56)	Controls (n=220)	P-value
Age			0.386
18-25 years	29 (51.8)	100 (45.5)
26-34 years	25 (44.6)	101 (45.9)
≥35 years	2 (3.6)	19 (8.6)
Education level			0.478
College degree or below	33 (58.9)	118 (53.6)
Bachelor’s degree or above	23 (41.1)	102 (46.4)
Household registration			0.283
Local	23 (41.1)	108 (49.1)
Non-local	33 (58.9)	112 (50.9)
Parity			0.041
Primipara	34 (60.7)	100 (45.5)
Multipara	22 (39.3)	120 (54.5)
Mode of delivery			0.028
Vaginal delivery	25 (44.6)	134 (60.9)
Cesarean section	31 (55.4)	86 (39.1)
Perineal tears			0.336
No	52 (92.9)	211 (95.9)
Yes	4 (7.1)	9 (4.1)
Apgar score			0.710
≥8	50 (89.3)	200 (90.9)
<8	6 (10.7)	20 (9.1)
Full-term birth			0.813
No	7 (12.5)	25 (11.4)
Yes	49 (87.5)	195 (88.6)
Used an analgesic pump			0.012
No	37 (66.1)	104 (47.3)
Yes	19 (33.9)	116 (52.7)
Cervical dilation			0.008
No	22 (39.3)	130 (59.1)
Yes	34 (60.7)	90 (40.9)
Transfer from the delivery room to the operating room for cesarean section			0.089
No	49 (87.5)	207 (94.1)
Yes	7 (12.5)	13 (5.9)
Admitted after midnight			0.002
No	26 (46.4)	151 (68.6)
Yes	30 (53.6)	69 (31.4)
Hypertension during pregnancy			0.030
No	41 (73.2)	188 (85.5)
Yes	15 (26.8)	32 (14.5)
Diabetes during pregnancy			0.508
No	50 (89.3)	189 (85.9)
Yes	6 (10.7)	31 (14.1)

Risk factors	PTSD patients (n=56)	Controls (n=220)	Adjusted OR (95% CI)	P-value
Parity			0.617 (0.324-1.172)	0.140
Primipara*	34 (60.7)	100 (45.5)
Multipara	22 (39.3)	120 (54.5)
Mode of delivery			2.102 (1.114-3.966)	0.022
Vaginal delivery*	25 (44.6)	134 (60.9)
Cesarean section	31 (55.4)	86 (39.1)
Used an analgesic pump			0.500 (0.259-0.966)	0.039
No*	37 (66.1)	104 (47.3)
Yes	19 (33.9)	116 (52.7)
Cervical dilation			2.245 (1.170-4.305)	0.015
No*	22 (39.3)	130 (59.1)
Yes	34 (60.7)	90 (40.9)
Admitted after midnight			3.203 (1.670-6.141)	<0.001
No*	26 (46.4)	151 (68.6)
Yes	30 (53.6)	69 (31.4)
Hypertension during pregnancy			1.971 (0.909-4.274)	0.086
No*	41 (73.2)	188 (85.5)
Yes	15 (26.8)	32 (14.5)

Numbers of risk factors	PTSD patients (n=56)	Controls (n=220)
0	4 (7.1)	23 (10.5)
1	13 (23.2)	72 (32.7)
2	31 (55.4)	87 (39.5)
3	13 (23.2)	35 (15.9)
4	5 (8.9)	3 (1.4)

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