PTSD Is Common in Pregnant Women
Among nulliparous women, those with histories of abuse or difficult miscarriage or abortion had the highest risk for PTSD.
Post-traumatic stress disorder (PTSD) during pregnancy is associated with maternal risk behaviors (e.g., smoking, substance use) and adverse neonatal and maternal outcomes. Diagnostic criteria for PTSD are shown in the table.
Researchers conducted a telephone survey to examine the prevalence of and risk factors for PTSD among 1581 nulliparous pregnant women. Participants (age, 
18; <28 weeks' gestation) were racially and ethnically diverse (minority women were 45% black, 4% Latina, 7% Asian, 2% Native American or Alaska Native, and 3% other) and were seen at eight Midwestern maternity clinics that served primarily privately or primarily publicly insured patients.
Overall, 22% of women reported no histories of trauma, 24% reported trauma exposures but no PTSD histories, 34% reported trauma exposures or histories of PTSD symptoms that did not meet diagnostic criteria (partial PTSD), 12% had histories of trauma and PTSD, and 8% met criteria for current PTSD. Prevalences of lifetime and current PTSD were higher at primarily publicly insured sites than at primarily privately insured sites (lifetime PTSD, 24% vs. 17%; current PTSD, 14% vs. 3%). Women with current PTSD were younger and initiated prenatal care later during pregnancy than did other women regardless of race, ethnicity, or socioeconomic and educational levels. Regression analysis showed that women who reported abuse or "a difficult time due to an abortion or miscarriage" had the highest risk for current PTSD. Each additional risk factor (e.g., socioeconomic status, type of worst trauma, previous mental health treatment, depression or anxiety diagnosis, family problems) further raised risk for PTSD during pregnancy. Prevalence of untreated PTSD was 7%.
