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Changes in PTSD symptomatology and mental health during pregnancy and postpartum

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Abstract

Changes in mental health symptoms throughout pregnancy and postpartum may impact a woman’s experience and adjustment during an important time. However, few studies have investigated these changes throughout the perinatal period, particularly changes in posttraumatic stress disorder (PTSD) symptoms. The purpose of this study was to examine longitudinal changes in PTSD, depression, and anxiety symptomatology during pregnancy and postpartum. Pregnant women of ethnically diverse backgrounds receiving services for prenatal care at an outpatient obstetric-gynecology clinic or private physicians’ office were assessed by interview on symptoms of PTSD, depression, anxiety, and general stress up to four times, including their first, second, and third trimester, and postpartum visits. Overall, during pregnancy there was a declining trend of PTSD symptoms. For anxiety, there was no overall significant change over time; however, anxiety symptoms were individually variable in the rate of change. For both depression and general stress symptoms, there was a declining trend, which was also variable in the individual rate of change among women during their pregnancy. Visual and post hoc analyses also suggest a possible peak in PTSD symptoms in the weeks prior to delivery. While most mental health symptoms may generally decrease during pregnancy, given the individual variability among women in the rate of change in symptoms, screening and monitoring of symptom fluctuations throughout the course of pregnancy may be needed. Further studies are needed to examine potential spiking of symptoms in the perinatal period.

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Acknowledgments and declarations

This research was supported, in part, by a Research Centers in Minority Institutions Award (P20 RR11091) from the National Center for Research Resources (NCRR), National Institutes of Health. Dissemination was supported in part by a National Institute on Alcohol Abuse and Alcoholism (NIAAA) and National Center on Minority Health and Disparities (NCMHD) Award (5U01AA014289-03) and The Queen’s Medical Center (QMC). Drs. Onoye and Goebert are faculty of the University of Hawai‘i (UH) John A. Burns School of Medicine as well as Senior Scientists at QMC. Dr. Matsu is also affiliated with QMC. The contents of this paper are solely the responsibility of the authors and do not represent the official views of NIAAA, NCMHD, NCRR, or QMC. The investigators thank the women and staff from the clinics that participated in and supported the study.

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Authors and Affiliations

  1. Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, 1356 Lusitana Street, 4th Floor, Honolulu, HI, 96813, USA

    Jane M. Onoye, Deborah A. Goebert, Leslie A. Morland, Courtenay R. Matsu & Fumiaki Hamagami

  2. Department of Internal Medicine, University of Manitoba, Health Sciences Centre, 810 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada

    Leigh Anne Shafer

  3. The Queen’s Medical Center, 1301 Punchbowl Street, Honolulu, HI, 96813, USA

    Jane M. Onoye, Deborah A. Goebert & Courtenay R. Matsu

  4. National Center for PTSD—Pacific Islands Division, Department of Veterans Affairs Pacific Islands Healthcare System, 3375 Koapaka St., Suite I-560, Honolulu, HI, 96819, USA

    Leslie A. Morland

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  1. Jane M. Onoye
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  2. Leigh Anne Shafer
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  3. Deborah A. Goebert
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Correspondence to Jane M. Onoye.

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Onoye, J.M., Shafer, L.A., Goebert, D.A. et al. Changes in PTSD symptomatology and mental health during pregnancy and postpartum. Arch Womens Ment Health 16, 453–463 (2013). https://doi.org/10.1007/s00737-013-0365-8

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