Differential predictors of birth-related posttraumatic stress disorder symptoms in mothers and fathers - A longitudinal cohort study

Victoria Kress; Tilmann von Soest; Marie Kopp; Pauline Wimberger; Susan Garthus-Niegel

doi:10.1016/j.jad.2021.05.058

Differential predictors of birth-related posttraumatic stress disorder symptoms in mothers and fathers - A longitudinal cohort study

J Affect Disord. 2021 Sep 1:292:121-130. doi: 10.1016/j.jad.2021.05.058. Epub 2021 May 27.

Authors

Victoria Kress¹, Tilmann von Soest², Marie Kopp¹, Pauline Wimberger³, Susan Garthus-Niegel⁴

Affiliations

¹ Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.
² PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.
³ Department of Gynecology and Obstetrics, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.
⁴ Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany; Department of Medicine, Faculty of Medicine, Medical School Hamburg, Hamburg, Germany; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway. Electronic address: susan.garthus-niegel@uniklinikum-dresden.de.

PMID: 34118611
DOI: 10.1016/j.jad.2021.05.058

Abstract

Background: Evidence on risk factors of birth-related posttraumatic stress disorder (PTSD) symptoms in mothers is increasing, whereas fathers are less examined. This study aims to determine differential predictors of PTSD symptoms in mothers and fathers.

Methods: Data derive from the DREAM study, including 1,146 mothers and 828 fathers. We assessed mental health, work, and sociodemographic factors during pregnancy, pregnancy- and birth-related factors, and birth-related PTSD symptoms using the Impact of Event Scale-Revised 8 weeks postpartum. Structural equation models were estimated to examine associations between predictors and latent factors of PTSD symptoms for mothers and fathers simultaneously. Scaled chi-square difference tests were used to investigate differences between both groups in predictors.

Results: Clinically relevant birth-related PTSD symptoms were found in 2.3% of mothers and 0.7% of fathers. Depressive and anxiety symptoms, pregnancy complications, and poorer subjective birth experience predicted PTSD symptoms in both groups. Additionally, lower support during birth and an unplanned cesarean section predicted PTSD symptoms in mothers, whereas lower job satisfaction, higher job burden, being first-time father, lower education, and mothers' lower support during birth were predictors for fathers. We found significant differences between groups regarding job burden during pregnancy, support during birth, and an unplanned cesarean section.

Limitations: Generalization of findings might be limited by self-selection bias and some systematic dropout.

Conclusions: Our results suggest differential predictors of PTSD symptoms in mothers and fathers. For fathers, less examined factors such as work factors may be important. Identifying differential risk factors may lead to customized prevention and treatment offers.

Keywords: Birth; DREAM study; Labor; PTSD; Postpartum disorders; Posttraumatic stress disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cesarean Section
Cohort Studies
Fathers*
Female
Humans
Longitudinal Studies
Male
Mothers
Pregnancy
Stress Disorders, Post-Traumatic* / diagnosis
Stress Disorders, Post-Traumatic* / epidemiology