Publication related to RSI or an RSI staff member
The Incidence of Postpartum Post-Traumatic Stress Disorder in Women Exposed to Adverse Childhood Experiences: A Systematic Review and Meta-Analysis.
BACKGROUND: Adverse childhood experiences (ACEs) are known contributors to lifelong mental health challenges. Despite studies linking ACEs to increased risk of adverse postpartum mental health outcomes, a systematic review on the occurrence of postpartum post-traumatic stress disorder (PTSD) in women with ACEs is lacking. METHODS: A systematic search was conducted in seven databases to retrieve studies from inception to January 31, 2024. A random-effects model was used to quantify weighted estimates of postpartum PTSD incidence. Statistical analysis was conducted using R software. RESULTS: Seven studies were included in the system review. One study was identified as an outlier and excluded from the meta-analysis. Among the six remaining studies, 1186 women exposed to ACEs were identified, with 249 of them experiencing postpartum PTSD. The estimated incidence of postpartum PTSD among women exposed to ACEs was 22.6% (95% confidence interval [CI] 16.1%-29.8%). Subgroup analysis revealed significant variations in incidence depending on study settings (p < 0.01) and PTSD assessment methods (p < 0.01). Due to multicollinearity among the primary variables, a meta-regression to identify factors influencing study heterogeneity was not conducted. CONCLUSION: The incidence of postpartum PTSD was 22.6% in women with ACEs, higher than that observed in the general obstetric population. This finding suggests the need to provide comprehensive postpartum care for these women.
Authors
- Zou, Linli, Zou L, School of Nursing, Southern Medical University, Guangzhou, China.
- Wang, Shu, Wang S, School of Nursing, Southern Medical University, Guangzhou, China.
- Chen, Jingfen, Chen J, School of Nursing, Southern Medical University, Guangzhou, China.
- Krewski, Daniel, Krewski D, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.; McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.; Risk Science International, Ottawa, Ontario, Canada.
- Wen, Shi Wu, Wen SW, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.; Department of Obstetrics & Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- Lai, Xiaolu, Lai X, School of Nursing, Southern Medical University, Guangzhou, China.
- Xie, Ri-Hua, Xie RH, School of Nursing, Southern Medical University, Guangzhou, China.; Women and Children Medical Research Center, Department of Nursing, Foshan Women and Children Hospital, Foshan, Guangdong, China.; Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada.
BACKGROUND: Adverse childhood experiences (ACEs) are known contributors to lifelong mental health challenges. Despite studies linking ACEs to increased risk of adverse postpartum mental health outcomes, a systematic review on the occurrence of postpartum post-traumatic stress disorder (PTSD) in women with ACEs is lacking. METHODS: A systematic search was conducted in seven databases to retrieve studies from inception to January 31, 2024. A random-effects model was used to quantify weighted estimates of postpartum PTSD incidence. Statistical analysis was conducted using R software. RESULTS: Seven studies were included in the system review. One study was identified as an outlier and excluded from the meta-analysis. Among the six remaining studies, 1186 women exposed to ACEs were identified, with 249 of them experiencing postpartum PTSD. The estimated incidence of postpartum PTSD among women exposed to ACEs was 22.6% (95% confidence interval [CI] 16.1%-29.8%). Subgroup analysis revealed significant variations in incidence depending on study settings (p < 0.01) and PTSD assessment methods (p < 0.01). Due to multicollinearity among the primary variables, a meta-regression to identify factors influencing study heterogeneity was not conducted. CONCLUSION: The incidence of postpartum PTSD was 22.6% in women with ACEs, higher than that observed in the general obstetric population. This finding suggests the need to provide comprehensive postpartum care for these women.
