Archives of Women's Mental Health

, Volume 21, Issue 2, pp 193–202 | Cite as

Trauma exposure and post-traumatic stress disorder in a cohort of pregnant Peruvian women

  • Elizabeth J. LeveyEmail author
  • Bizu Gelaye
  • Karestan Koenen
  • Qiu-Yue Zhong
  • Archana Basu
  • Marta B. Rondon
  • Sixto Sanchez
  • David C. Henderson
  • Michelle A. Williams
Original Article


Women have a higher prevalence of post-traumatic stress disorder (PTSD) than men, with a peak during the reproductive years. PTSD during pregnancy adversely impacts maternal and infant health outcomes. The objectives of this study were to estimate the prevalence of antepartum PTSD symptoms in a population of pregnant Peruvian women and to examine the impact of number of traumatic events and type of trauma experienced. The Traumatic Events Questionnaire was used to collect data about traumatic exposures. The Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C) was used to assess PTSD. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). Three thousand three hundred seventy-two pregnant women were interviewed. Of the 2920 who reported experiencing one or more traumatic events, 41.8% met criteria for PTSD (PCL-C score ≥ 26). A quarter of participants had experienced four or more traumas, and 60.5% of those women had PTSD. Interpersonal trauma was most strongly associated with PTSD (aOR, 3.20; 95% CI, 2.74–3.74), followed by unspeakable trauma (aOR, 2.87; 95% CI, 2.35–3.50), and structural trauma (aOR, 1.39; 95% CI, 1.15–1.67). These findings indicate the high prevalence of PTSD during pregnancy in the Peruvian population, which is relevant to other countries suffering from terrorism, war, or high rates of violence. This underscores the importance of screening for PTSD in pregnancy.


PTSD Pregnancy Trauma Peru TEQ 



The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en Salud (AC PROESA), Peru, and Instituto Nacional Materno Perinatal (INMP), Peru for their expert technical assistance with this research.

Funding information

This research was supported by awards from the National Institutes of Health (T32-MH-093310 and R01-HD-059835). The NIH had no further role in study design; in the collection, analysis and interpretation of data, in the writing of the report, and in the decision to submit the paper for publication.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

737_2017_776_MOESM1_ESM.docx (12 kb)
ESM 1 (DOCX 12 kb)
737_2017_776_MOESM2_ESM.docx (13 kb)
ESM 2 (DOCX 13 kb)


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Copyright information

© Springer-Verlag GmbH Austria 2017

Authors and Affiliations

  • Elizabeth J. Levey
    • 1
    • 2
    • 3
    Email author
  • Bizu Gelaye
    • 4
  • Karestan Koenen
    • 1
    • 2
    • 4
  • Qiu-Yue Zhong
    • 4
  • Archana Basu
    • 1
    • 2
    • 4
  • Marta B. Rondon
    • 5
  • Sixto Sanchez
    • 6
  • David C. Henderson
    • 7
    • 8
  • Michelle A. Williams
    • 4
  1. 1.The Chester M. Pierce, MD Division of Global PsychiatryMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Institute for Juvenile ResearchUniversity of Illinois College of MedicineChicagoUSA
  4. 4.Harvard T.H. Chan School of Public HealthBostonUSA
  5. 5.Universidad Peruana Cayetano HerediaLimaPeru
  6. 6.Universidad Peruana de Ciencias AplicadasLimaPeru
  7. 7.Department of PsychiatryBoston Medical CenterBostonUSA
  8. 8.Boston University School of MedicineBostonUSA

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