Skip to main content Accessibility help
×
Home

The impact of postpartum post-traumatic stress disorder symptoms on child development: a population-based, 2-year follow-up study

  • S. Garthus-Niegel (a1) (a2) (a3), S. Ayers (a4), J. Martini (a5), T. von Soest (a6) and M. Eberhard-Gran (a2) (a7) (a8)...

Abstract

Background

Against the background of very limited evidence, the present study aimed to prospectively examine the impact of maternal postpartum post-traumatic stress disorder (PTSD) symptoms on four important areas of child development, i.e. gross motor, fine motor, communication and social–emotional development.

Method

This study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record as well as questionnaire data from 8 weeks and 2 years postpartum were used (n = 1472). The domains of child development that were significantly correlated with PTSD symptoms were entered into regression analyses. Interaction analyses were run to test whether the influence of postpartum PTSD symptoms on child development was moderated by child sex or infant temperament.

Results

Postpartum PTSD symptoms had a prospective relationship with poor child social–emotional development 2 years later. This relationship remained significant even when adjusting for confounders such as maternal depression and anxiety or infant temperament. Both child sex and infant temperament moderated the association between maternal PTSD symptoms and child social–emotional development, i.e. with increasing maternal PTSD symptom load, boys and children with a difficult temperament were shown to have comparatively higher levels of social–emotional problems.

Conclusions

Examining four different domains of child development, we found a prospective impact of postpartum PTSD symptoms on children's social–emotional development at 2 years of age. Our findings suggest that both boys and children with an early difficult temperament may be particularly susceptible to the adverse impact of postpartum PTSD symptoms. Additional studies are needed to further investigate the mechanisms at work.

Copyright

Corresponding author

*Address for correspondence: S. Garthus-Niegel, Institute and Policlinic of Occupational and Social Medicine, TU Dresden, Faculty of Medicine, Fetscherstr. 74, 01307 Dresden, Germany. (Email: susan.garthus-niegel@tu-dresden.de)

References

Hide All
Ainsworth, MDS, Blehar, MC, Waters, E, Wal, SN (2015). Patterns of Attachment: A Psychological Study of the Strange Situation. Psychology Press: New York.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Publishing: Arlington, VA.
Ayers, S, Bond, R, Bertullies, S, Wijma, K (2016). The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychological Medicine 46, 11211134.
Ayers, S, Wright, DB, Wells, N (2007). Symptoms of post-traumatic stress disorder in couples after birth: association with the couple's relationship and parent–baby bond. Journal of Reproductive and Infant Psychology 25, 4050.
Ballard, CG, Stanley, AK, Brockington, IF (1995). Post-traumatic stress disorder (PTSD) after childbirth. British Journal of Psychiatry 166, 525528.
Bates, JE, Freeland, CA, Lounsbury, ML (1979). Measurement of infant difficultness. Child Development 50, 794803.
Bayley, N (2006). Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III). Psychological Corporation: San Antonio, TX.
Beck, CT, Watson, S (2008). Impact of birth trauma on breast-feeding: a tale of two pathways. Nursing Research 57, 228236.
Cox, JL, Holden, JM, Sagovsky, R (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150, 782786.
Eberhard-Gran, M, Tambs, K, Opjordsmoen, S, Skrondal, A, Eskild, A (2003). A comparison of anxiety and depressive symptomatology in postpartum and non-postpartum mothers. Social Psychiatry and Psychiatric Epidemiology 38, 551556.
Efron, B, Tibshirani, RJ (1993). An Introduction to the Bootstrap. Chapman and Hall: New York.
Elmir, R, Schmied, V, Wilkes, L, Jackson, D (2010). Women's perceptions and experiences of a traumatic birth: a meta-ethnography. Journal of Advanced Nursing 66, 21422153.
Eurostat Statistics Explained (2015). Fertility statistics (http://ec.europa.eu/eurostat/statistics-explained/index.php/Fertility_statistics).
Fenech, G, Thomson, G (2014). ‘Tormented by ghosts from their past’: a meta-synthesis to explore the psychosocial implications of a traumatic birth on maternal well-being. Midwifery 30, 185193.
Garthus-Niegel, S, Ayers, S, von Soest, T, Torgersen, L, Eberhard-Gran, M (2014 a). Maintaining factors of posttraumatic stress symptoms following childbirth: a population-based, two-year follow-up study. Journal of Affective Disorders 172, 146152.
Garthus-Niegel, S, von Soest, T, Knoph, C, Simonsen, TB, Torgersen, L, Eberhard-Gran, M (2014 b). The influence of women's preferences and actual mode of delivery on post-traumatic stress symptoms following childbirth: a population-based, longitudinal study. BMC Pregnancy and Childbirth 14, 191.
Glasheen, C, Richardson, GA, Fabio, A (2010). A systematic review of the effects of postnatal maternal anxiety on children. Archives of Women's Mental Health 13, 6174.
Grekin, R, O'Hara, MW (2014). Prevalence and risk factors of postpartum posttraumatic stress disorder: a meta-analysis. Clinical Psychology Review 34, 389401.
Horowitz, M, Wilner, N, Alvarez, W (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine 41, 209218.
Horta, BL, Bahl, R, Martines, JC, Victora, CG (2007). Evidence on the Long-Term Effects of Breastfeeding: Systematic Reviews and Meta-Analyses. World Health Organization: Geneva.
Ip, S, Chung, M, Raman, G, Chew, P, Magula, N, DeVine, D, Trikalinos, T, Lau, J (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment no. 153, 1186.
Lau, C, Rogers, JM, Desai, M, Ros, MG (2011). Fetal programming of adult disease: implications for prenatal care. Obstetrics and Gynecology 117, 978985.
Martin, JA, Hamilton, BE, Osterman, MJK, Curtin, SC, Mathews, TJ (2015). Births: Final Data for 2013. National Vital Statistics Reports, vol. 64, no. 1. National Center for Health Statistics: Hyattsville, MD (http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf). Accessed September 2016.
McKenzie-McHarg, K, Ayers, S, Ford, E, Horsch, A, Jomeen, J, Sawyer, A, Stramrood, C, Thomson, G, Slade, P (2015). Post-traumatic stress disorder following childbirth: an update of current issues and recommendations for future research. Journal of Reproductive and Infant Psychology 33, 219237.
Moleman, N, van der Hart, O, van der Kolk, BA (1992). The partus stress reaction: a neglected etiological factor in postpartum psychiatric disorders. Journal of Nervous and Mental Disease 180, 271272.
Neal, LA, Busuttil, W, Rollins, J, Herepath, R, Strike, P, Turnbul, G (1994). Convergent validity of measures of post-traumatic stress disorder in a mixed military and civilian population. Journal of Traumatic Stress 7, 447455.
Nettelbladt, P, Hansson, L, Stefansson, CG, Borgquist, L, Nordstrom, G (1993). Test characteristics of the Hopkins Symptom Check List-25 (HSCL-25) in Sweden, using the Present State Examination (PSE-9) as a caseness criterion. Social Psychiatry and Psychiatric Epidemiology 28, 130133.
Nicholls, K, Ayers, S (2007). Childbirth-related post-traumatic stress disorder in couples: a qualitative study. British Journal of Health Psychology 12, 491509.
Nilsen, RM, Vollset, SE, Gjessing, HK, Skjaerven, R, Melve, KK, Schreuder, P, Alsaker, ER, Haug, K, Daltveit, AK, Magnus, P (2009). Self-selection and bias in a large prospective pregnancy cohort in Norway. Paediatric and Perinatal Epidemiology 23, 597608.
Olde, E, Kleber, RJ, van der Hart, O, Pop, VJM (2006). Childbirth and posttraumatic stress responses: a validation study of the Dutch Impact of Event Scale-Revised. European Journal of Psychological Assessment 22, 259267.
Parfitt, Y, Ayers, S (2009). The effect of postnatal symptoms of post-traumatic stress and depression on the couple's relationship and parent–baby bond. Journal of Reproductive and Infant Psychology 27, 127142.
Parfitt, Y, Pike, A, Ayers, S (2014). Infant developmental outcomes: a family systems perspective. Infant and Child Development 23, 353373.
Rahman, A, Surkan, PJ, Cayetano, CE, Rwagatare, P, Dickson, KE (2013). Grand challenges: integrating maternal mental health into maternal and child health programmes. PLoS Medicine 10, e1001442.
Ramchandani, P, Stein, A, Evans, J, O'Connor, TG (2005). Paternal depression in the postnatal period and child development: a prospective population study. Lancet 365, 22012205.
Sharp, D, Hay, DF, Pawlby, S, Schmücker, G, Allen, H, Kumar, R (1995). The impact of postnatal depression on boys’ intellectual development. Journal of Child Psychology and Psychiatry, and Allied Disciplines 36, 13151336.
Squires, J, Bricker, D, Twombly, E (2005). The ASQ:SE User's Guide: for the Ages & Stages Questionnaires, Social–Emotional: A Parent-Completed, Child-Monitoring Program for Social-Emotional Behaviors. Paul H. Brookes Publishing Co.: Baltimore, MD.
Squires, J, Twombly, E, Bricker, D, Potter, L (2009). ASQ-3 User's Guide. Paul H. Brookes Publishing Co.: Baltimore, MD.
Stein, A, Pearson, RM, Goodman, SH, Rapa, E, Rahman, A, McCallum, M, Howard, LM, Pariante, CM (2014). Effects of perinatal mental disorders on the fetus and child. Lancet 384, 18001819.
Tucker, J, McGuire, W (2004). Epidemiology of preterm birth. BMJ 329, 675678.
World Health Organization (2016). Maternal mental health (http://www.who.int/mental_health/maternal-child/maternal_mental_health/en/). Accessed March 2016.

Keywords

Related content

Powered by UNSILO
Type Description Title
PDF
Supplementary materials

Garthus-Niegel supplementary material
Garthus-Niegel supplementary material 1

 PDF (186 KB)
186 KB
WORD
Supplementary materials

Garthus-Niegel supplementary material
Garthus-Niegel supplementary material 2

 Word (40 KB)
40 KB

The impact of postpartum post-traumatic stress disorder symptoms on child development: a population-based, 2-year follow-up study

  • S. Garthus-Niegel (a1) (a2) (a3), S. Ayers (a4), J. Martini (a5), T. von Soest (a6) and M. Eberhard-Gran (a2) (a7) (a8)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.