Postpartum outcomes of a pilot prenatal care-based psychosocial intervention for PTSD during pregnancy
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This study examines postpartum posttraumatic stress disorder (PTSD) symptoms and secondary outcomes including postpartum depression and birth outcomes for pregnant women who screened positive for PTSD and received a psychosocial education intervention compared to women with PTSD in the usual prenatal care setting. All women entering prenatal care at two federally qualified health centers were screened for symptoms of current PTSD; one site was selected randomly to have prenatal care advocates deliver eight Seeking Safety topics for women with clinical or subclinical PTSD. Women were not blind to condition. Baseline and postpartum interviews, including demographic characteristics and assessment of mental health, social support, and coping skills, were conducted. Medical record data was collected to document preterm delivery and low birth weight. Of the 149 participants at baseline, 128 (86%) participated in the postpartum interview. Intervention women, compared to controls, significantly decreased PTSD symptoms, and showed a non-significant trend for improved social support. However, depression, coping, and birth outcomes did not differ. This study suggests some initial support for the Seeking Safety intervention in prenatal care settings and requires further research to determine the best approaches to its implementation.
KeywordsPrenatal care PTSD Pregnancy Birth outcomes Postpartum Health services Psychosocial intervention
The authors wish to thank the prenatal care teams, prenatal advocates, and administrators of the Edward M Kennedy Community Health Center and the Family Health Center of Worcester MA for their dedication to carrying out this study, and all the women who participated in screening and study activities. We also wish to thank our consultant, Lisa Najavits, PhD, for her guidance and review of an earlier version of this paper, Robin Clark, PhD for his guidance on the revised manuscript, and our Advisory Committee: Denise Hien, PhD, City University of New York; Wayne Katon, MD, University of Washington (deceased); Esteban Cardemil, PhD, Clark University; and Stacey Cunningham, MSW, MPH, National Healthy Start Association for assistance with study planning and problem solving.
This study was supported by grant R40MC23633 from the Maternal and Child Health Research Program, Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services. The funding source had no role in design, data collection, analysis, interpretation or writing of this manuscript.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
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