From childhood to adult trauma and negative birth experiences: distal and proximal factors associated with childbirth-related posttraumatic stress symptoms.

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Original abstract

<h4>Background</h4>Childbirth-related posttraumatic stress symptoms (CB-PTSS) have been recognized as a serious postpartum complication. Although childhood maltreatment (CM) is a well-established vulnerability factor for stress-related mental disorders, including posttraumatic stress disorder (PTSD), its role in CB-PTSS remains largely unexplored.<h4>Objective</h4>This study aimed to investigate the association between CM and CB-PTSS at 12 months postpartum, while also considering other major risk factors for CB-PTSS, such as adult trauma and subjective birth experiences (SBEs). In exploratory analyses, we tested whether CM differentially predicted childbirth-related PTSD symptom clusters (intrusion, avoidance, hyperarousal).<h4>Methods</h4><i>N</i> = 111 individuals provided retrospective information on CM and SBEs, as well as information on current CB-PTSS via online questionnaires at 12 months postpartum. Adult trauma was assessed as part of a clinical interview with a trauma checklist. Hierarchical regression models examined whether adult trauma, SBEs, and CM predicted CB-PTSS.<h4>Results</h4>Both adult trauma (<i>p</i> = .018) and SBEs predicted higher levels of CB-PTSS (<i>p</i> < .001). Beyond those variables, CM was a significant predictor of CB-PTSS (<i>p</i> = .016). Specifically, CM significantly predicted higher levels of childbirth-related intrusion (<i>p</i> < .01), but not avoidance (<i>p</i> = .576) or hyperarousal symptoms (<i>p</i> = .078).<h4>Conclusion</h4>CM may represent a key antepartum vulnerability factor for CB-PTSS, underscoring the far-reaching impact of CM on peripartum mental health. At the same time, more proximal experiences, such as negative SBEs, may critically impact the risk for adverse postpartum outcomes. Further research is needed to elucidate the complex interplay between CM, SBEs, and CB-PTSS, while interdisciplinary, trauma-informed strategies are crucial to prevent and treat CB-PTSS.

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