Predictors of PTSD Symptoms Following Childbirth
Predictors of PTSD Symptoms Following Childbirth
The participants retained in the analyses showed a mean PDS score of M = 8.61 (SD = 8.51), with a large range of scores (0–44). When applying the criteria suggested by Foa et al. and Ehring et al., 27 participants (12.05%) showed signs of probable PTSD, two of whom indicated that they had already suffered from these symptoms prior to childbirth. Therefore, a probable PTSD following childbirth was found in 25 participants (11.16%).
Regarding prenatal variables, age and wellbeing during pregnancy were significantly negatively correlated with the PDS score (see Table 1). Positive associations with PDS scores were found for the dichotomous prenatal variables history of a sexual trauma, history of a non-sexual other trauma and complications during pregnancy (see Table 2). Regarding birth-related variables, negative peritraumatic emotions (PEQ) and complications during childbed both showed a significant positive correlation with the PDS score, whereas wellbeing during childbed was significantly negatively correlated (see Table 1). PDS scores also differed depending on the birth modus, F(4, 219) = 7.07, p < .001, ηp = .11. Post-hoc comparisons using Scheffé tests indicated that the mean PDS score for the emergency caesarean section (M = 16.17, SD = 11.04, p = .001) and for the secondary caesarean section (M = 13.53, SD = 9.74, p = .046) were both significantly higher than the PDS score for women who had a normal vaginal delivery (M = 7.04, SD = 7.56). All other post hoc comparisons did not reach statistical significance. Therefore, for the regression analysis two dichotomous variables were created to estimate the influence of either a secondary or an emergency section ("yes"/"no") or a normal vaginal birth ("yes"/"no").
Both quality and quantity of postnatal social support showed a significant negative correlation with the PDS score (see Table 1). All cognitive variables were significantly positively correlated with the PDS score (see Table 3). None of the subscales of the PTCI showed a higher correlation with the PDS score than the overall score. Therefore only the overall score was retained in the regression analysis.
Results of the hierarchical regression analysis are shown in Table 4. The first model including the prenatal variables history of sexual trauma, history of other previous trauma, complications during pregnancy and wellbeing during pregnancy (Model 1), showed a significant prediction of PDS scores, R = .11, F(4, 219) = 5.13, p < .001. When birth-related variables were additionally included (Model 2), the prediction was significantly improved with an additional 33% of variance in PDS scores accounted for, R = .43, ΔR = .33; F(6, 213) = 20.36, p < .001. The inclusion of postnatal social support (Model 3) did not significantly improve the prediction of the PDS score, ΔR = .01, F(2, 211) = 1.95, p = .15. Following inclusion of the cognitive variables in the fourth block (Model 4), the prediction was further improved by a significant amount, R = .68, ΔR = .24; F(5, 206) = 29.61, p < .001.
Results
Level of PTSD in the Current Sample
The participants retained in the analyses showed a mean PDS score of M = 8.61 (SD = 8.51), with a large range of scores (0–44). When applying the criteria suggested by Foa et al. and Ehring et al., 27 participants (12.05%) showed signs of probable PTSD, two of whom indicated that they had already suffered from these symptoms prior to childbirth. Therefore, a probable PTSD following childbirth was found in 25 participants (11.16%).
Bivariate Correlations of Potential Predictors With PTSD Symptoms
Regarding prenatal variables, age and wellbeing during pregnancy were significantly negatively correlated with the PDS score (see Table 1). Positive associations with PDS scores were found for the dichotomous prenatal variables history of a sexual trauma, history of a non-sexual other trauma and complications during pregnancy (see Table 2). Regarding birth-related variables, negative peritraumatic emotions (PEQ) and complications during childbed both showed a significant positive correlation with the PDS score, whereas wellbeing during childbed was significantly negatively correlated (see Table 1). PDS scores also differed depending on the birth modus, F(4, 219) = 7.07, p < .001, ηp = .11. Post-hoc comparisons using Scheffé tests indicated that the mean PDS score for the emergency caesarean section (M = 16.17, SD = 11.04, p = .001) and for the secondary caesarean section (M = 13.53, SD = 9.74, p = .046) were both significantly higher than the PDS score for women who had a normal vaginal delivery (M = 7.04, SD = 7.56). All other post hoc comparisons did not reach statistical significance. Therefore, for the regression analysis two dichotomous variables were created to estimate the influence of either a secondary or an emergency section ("yes"/"no") or a normal vaginal birth ("yes"/"no").
Both quality and quantity of postnatal social support showed a significant negative correlation with the PDS score (see Table 1). All cognitive variables were significantly positively correlated with the PDS score (see Table 3). None of the subscales of the PTCI showed a higher correlation with the PDS score than the overall score. Therefore only the overall score was retained in the regression analysis.
Hierarchical Multiple Regression Analysis
Results of the hierarchical regression analysis are shown in Table 4. The first model including the prenatal variables history of sexual trauma, history of other previous trauma, complications during pregnancy and wellbeing during pregnancy (Model 1), showed a significant prediction of PDS scores, R = .11, F(4, 219) = 5.13, p < .001. When birth-related variables were additionally included (Model 2), the prediction was significantly improved with an additional 33% of variance in PDS scores accounted for, R = .43, ΔR = .33; F(6, 213) = 20.36, p < .001. The inclusion of postnatal social support (Model 3) did not significantly improve the prediction of the PDS score, ΔR = .01, F(2, 211) = 1.95, p = .15. Following inclusion of the cognitive variables in the fourth block (Model 4), the prediction was further improved by a significant amount, R = .68, ΔR = .24; F(5, 206) = 29.61, p < .001.