Trauma and traumatic stress in a sample of pregnant women

Abstract

Objective To examine the construct validity of the 9 item Traumatic Events Questionnaire (TEQ) and to evaluate the extent to which experiences of trauma assessed using the TEQ are associated with symptoms of psychiatric disorders among 3,342 pregnant women in Lima, Peru. Methods Symptoms of depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS) while the PTSD Checklist-civilian (PCL-C) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess symptoms of PTSD and generalized anxiety. Hierarchical logistic regression procedures were used to evaluate relations between TEQ and symptoms of psychiatric disorders. Results The majority of participants (87.8%) experienced at least one traumatic event (mean=2.5 events). The trauma occurrence score was moderately correlated with symptoms of PTSD (PCL-C: rho=0.38, P-value<0.0001), depression (EPDS: rho=0.31, P-value<0.0001; PHQ-9: rho=0.20, P-value <0.0001), and GAD (GAD-7: rho=0.29, P-value<0.0001). Stronger correlations were observed between the trauma intensity score with symptoms of psychiatric disorders (PCL-C: rho=0.49, P-value<0.0001; EPDS: rho=0.36, P-value<0.0001; PHQ-9: rho=0.31, P-value<0.0001; GAD-7: rho=0.39 P-value<0.0001). Conclusion Given the high burden of trauma experiences and the enduring adverse consequences on maternal and child health, there is an urgent need for integrating evidence-based trauma informed care programs in obstetrical practices serving Peruvian patients.

Client Experiences of Trauma-Informed Care in Social Service Agencies

“…More than half of the trauma exposures involved witnessing death or serious injury, the unexpected death of a loved one, being mugged, being in a life-threatening automobile accident, and experiencing a life-threatening illness or injury (Benjet et al, 2016). The experiences of trauma rarely occurred in isolation, rather people with a history of trauma exposure were more likely to have experienced to multiple traumatic events (Benjet et al, 2016;Gelaye et al, 2017). While the identity of the specific agencies in this study are masked to protect the subjects, we discuss the types of problems served by these agencies to highlight specific trauma risks in each setting.…”

“…Pregnant women are at risk for both experiencing trauma and re-experiencing past trauma during the prenatal, delivery, and postpartum periods with long and short term implications for both mother and child (Gelaye et al, 2017;Wosu, Gelaye, & Williams, 2015).…”

“…But there can be long term, intergenerational psychological impacts as well, with a mother's history of childhood trauma impacting the behaviors of their school age children (Babcock Fenerci, Chu, & DePrince, 2016). In mothers, trauma intensity scores are strongly correlated with postpartum depression or depressive symptoms (Gelaye et al, 2017;Wosu et al, 2015).…”

Realizing Women Living with HIV’s Reproductive Rights in the Era of ART: The Negative Impact of Non-consensual HIV Disclosure on Pregnancy Decisions Amongst Women Living with HIV in a Canadian Setting

“…To address the impacts of traumatic experiences (e.g., intimate partner violence, traumatic events of stigma/discrimination) there have been increasing calls for trauma-informed approaches to care, including as part of HIV care(31–33) and perinatal care(34, 35). Trauma-informed care approaches recognize and respond to the impacts of traumatic events and embrace the core principles of trauma-informed care: trustworthiness, safety, peer-support, collaboration, empowerment, and respect for cultural/historic and gender issues in care(36).…”

Maternal Lifetime Trauma and Birthweight: Effect Modification by In Utero Cortisol and Child Sex

“…Notably, the limited number of studies that consider a woman’s lifetime stress consistently support associations with lower birthweight 6, 7 , and effects persist when accounting for stress in pregnancy 7 . Our group 21 and others 22 demonstrate high rates of trauma exposure in lower income, ethnic minority women of childbearing age. Trauma can result in altered psychophysiological states that persist years after an event which, when carried into pregnancy, can impact the developing fetus 23 .…”