Grundström Hanna, Malmquist Anna, Thorsell Malin, Nieminen Katri
Department of Obstetrics and Gynecology in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
J Obstet Gynaecol. 2025 Dec;45(1):2553197. doi: 10.1080/01443615.2025.2553197. Epub 2025 Sep 4.
Pregnancy and childbirth are vulnerable periods for women's mental health, with common occurrences of postnatal depression (PPD), postpartum post-traumatic stress symptoms (PP-PTSS) and postnatal severe fear of childbirth (PP-FOC). While previous trauma is linked to higher rates of postpartum psychological difficulties, the mechanisms and variations by parity and sociodemographic factors remain poorly understood. The aim of this study was to compare the prevalence of PPD symptoms, postnatal post-traumatic stress disorder (PP-PTSD), PP-PTSS and PP-FOC between women with a history of trauma and those without. Additionally, the study aimed to analyse the prevalence of previous trauma and postnatal mental health problems in subgroups of primi- and multiparous women, and to investigate how trauma influenced mental health in relation to sociodemographic characteristics.
This was a cross-sectional study including 619 women who had given birth at five maternity clinics in Sweden. Data for the survey were collected online using validated instruments to measure PPD, PP-PTSD, PP-PTSS and PP-FOC. Data were analysed using Chi-squared tests, independent -tests and uni- and multivariable regression.
Women with a trauma history ( = 298) showed significantly higher rates of PPD (26% vs. 13%) and PTSD (5% vs. 2%) than those without a trauma history ( = 321). Previous trauma, age and parity significantly influenced postnatal outcomes, with trauma having the most substantial impact.
A history of trauma is correlated to higher risk of postpartum mental health problems, while previous births may offer some protection, especially against PP-PTSS and PP-FOC. Early identification and targeted support for women with trauma histories are recommended.
怀孕和分娩是女性心理健康的脆弱时期，产后抑郁症（PPD）、产后创伤后应激症状（PP-PTSS）和产后严重分娩恐惧（PP-FOC）很常见。虽然既往创伤与产后心理问题的较高发生率有关，但相关机制以及经产次和社会人口学因素的差异仍知之甚少。本研究的目的是比较有创伤史和无创伤史女性的PPD症状、产后创伤后应激障碍（PP-PTSD）、PP-PTSS和PP-FOC的患病率。此外，该研究旨在分析初产妇和经产妇亚组中既往创伤和产后心理健康问题的患病率，并调查创伤如何影响与社会人口学特征相关的心理健康。
这是一项横断面研究，纳入了在瑞典五家产科诊所分娩的619名女性。使用经过验证的工具在线收集调查数据，以测量PPD、PP-PTSD、PP-PTSS和PP-FOC。数据采用卡方检验、独立t检验以及单变量和多变量回归进行分析。
有创伤史的女性（n = 298）的PPD（26%对13%）和PTSD（5%对2%）发生率显著高于无创伤史的女性（n = 321）。既往创伤、年龄和经产次对产后结局有显著影响，其中创伤的影响最大。
创伤史与产后心理健康问题的较高风险相关，而既往分娩可能提供一定保护，尤其是预防PP-PTSS和PP-FOC。建议对有创伤史的女性进行早期识别和针对性支持。
