Post-traumatic stress disorder, child abuse history, birthweight and gestational age: a prospective cohort study: PTSD and perinatal outcomes
Open accessAbstract
OBJECTIVE: To determine the extent to which prenatal post-traumatic stress disorder (PTSD) is associated with lower birthweight and shorter gestation, and to explore the effects of childhood maltreatment as the antecedent trauma exposure. DESIGN: Prospective three-cohort study. SETTING: Ann Arbor and Detroit, Michigan, United States. SAMPLE: In all, 839 diverse nulliparas in PTSD-positive (n = 255), trauma-exposed, resilient (n = 307) and non-exposed to trauma (n = 277) cohorts. METHODS: Standardised telephone interview before 28 weeks of gestation to ascertain trauma history, PTSD, depression, substance use, mental health treatment history and sociodemographics, with chart abstraction to obtain chronic condition history, antepartum complications and prenatal care data, as well as outcomes. MAIN OUTCOME MEASURES: Infant birthweight and gestational age per delivery record. RESULTS: Infants born to women with PTSD during pregnancy had a mean birthweight 283 g less than infants of trauma-exposed, resilient women and 221 g less than infants of non-exposed women (F(3,835) = 5.4, P = 0.001). PTSD was also associated with shorter gestation in multivariate models that took childhood abuse history into account. Stratified models indicated that PTSD subsequent to child abuse trauma exposure was most strongly associated with adverse outcomes. PTSD was a stronger predictor than African American race of shorter gestation and a nearly equal predictor of birthweight. Prenatal care was not associated with better outcomes among women abused in childhood. CONCLUSIONS: Abuse-related PTSD may be an additional or alternative explanation for adverse perinatal outcomes associated with low socio-economic status and African American race in the USA. Biological and interventions research is warranted along with replication studies in other nations.
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PTSD during pregnancy is associated with adverse perinatal outcomes, including preterm birth, low infant birthweight, postpartum depression, and impaired maternal-infant bonding.
“PTSD during pregnancy is associated with adverse perinatal outcomes, including preterm birth, low infant birthweight, postpartum depression, and impaired maternal-infant bonding [3–5].”
From Written exposure therapy for treatment of perinatal PTSD among women with comorbid PTSD and SUD: A pilot study examining feasibility, acceptability, and preliminary effectiveness (2023) · cites this paper as [4]
The Results and Discussion report that PTSD during pregnancy was associated with lower birthweight and shorter gestation, and the Discussion gives a preterm-birth rate for the PTSD group. The Discussion identifies postpartum mental health and bonding as outcomes needing further study; it does not report associations with postpartum depression or impaired maternal–infant bonding. Page numbers are not available in the supplied passages. (LLM, conf=0.91)
Experimental — accuracy not yet measuredPregnant individuals with comorbid PTSD/SUD are at especially high risk for adverse perinatal outcomes.
“Pregnant individuals with comorbid PTSD and Substance Use Disorder (PTSD/SUD) are a subgroup that is at especially high risk for adverse perinatal outcomes [4,9].”
From Written exposure therapy for treatment of perinatal PTSD among women with comorbid PTSD and SUD: A pilot study examining feasibility, acceptability, and preliminary effectiveness (2023) · cites this paper as [4]
The Discussion (page not provided) links prenatal PTSD to lower birth weight and shorter gestation, and the Results report that substance use contributed to lower-birth-weight risk among childhood abuse survivors. The paper does not identify a comorbid PTSD/Substance Use Disorder subgroup or show that this subgroup is at especially high risk; it identifies women with childhood-abuse-related PTSD as most vulnerable. (LLM, conf=0.86)
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Cites
Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer: 2006–2008
Cantwell, R., Clutton-Brock, T. H., COOPER, G. M., Dawson, A. H., Drife, J., Garrod, D., Harper, A., Hulbert, D., Lucas, S. B., McClure, J. H., et al. (2011) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2010.02847.x · Cited by 3,024 · see citing works
Wittchen, H.-U. (1994) · Journal of Psychiatric Research · doi:10.1016/0022-3956(94)90036-1 · Cited by 2,348 · see citing works
Resnick, H. S., Kilpatrick, D. G., Dansky, B. S., Saunders, B. E., & al, E. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.61.6.984 · Cited by 1,868 · see citing works
Resnick, H. S., Kilpatrick, D. G., Dansky, B. S., Saunders, B. E., & Best, C. L. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.61.6.984 · Cited by 1,868 · see citing works
Assessing Psychological Trauma and PTSD
Allden, K. (1998) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199807000-00018 · Cited by 1,709 · see citing works
The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders
Heim, C., Ehlert, U., & Hellhammer, D. H. (2000) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(99)00035-9 · Cited by 1,688 · see citing works
Cloitre, M., Stolbach, B. C., Herman, J. L., Kolk, B. V. D., Pynoos, R., Wang, J., & Petkova, E. (2009) · Journal of Traumatic Stress · doi:10.1002/jts.20444 · Cited by 1,473 · see citing works
Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma
van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005) · Journal of Traumatic Stress · doi:10.1002/jts.20047 · Cited by 1,284 · see citing works
Assessing for Abuse During Pregnancy
McFARLANE, J. M. (1992) · JAMA · doi:10.1001/jama.1992.03480230068030 · Cited by 1,060 · see citing works
Violence, Abuse, and Crime Exposure in a National Sample of Children and Youth
David Finkelhor, B., Turner, H. A., Ormrod, R. K., & Hamby, S. L. (2009) · PEDIATRICS · doi:10.1542/peds.2009-0467 · Cited by 1,031 · see citing works
Owens, P. C., Smith, R., Brinsmead, M. W., Hall, C., Foureur, M. J., Hurt, D., Lovelock, M., Chan, E.-C., Cubis, J., & Lewin, T. J. (1987) · Life Sciences · doi:10.1016/0024-3205(87)90603-5 · Cited by 958 · see citing works
Lifetime Events and Posttraumatic Stress Disorder in 4 Postconflict Settings
de Jong, J. T. V. M. (2001) · JAMA · doi:10.1001/jama.286.5.555 · Cited by 807 · see citing works
CREAMER, M., Burgess, P. M., & McFARLANE, A. C. (2001) · Psychological Medicine · doi:10.1017/s0033291701004287 · Cited by 757 · see citing works
Brain activation in PTSD in response to trauma-related stimuli
Liberzon, I., Taylor, S. F., Amdur, R., Jung, T. D., Chamberlain, K. R., Minoshima, S., Koeppe, R. A., & Fig, L. M. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00246-7 · Cited by 635 · see citing works
Self-citationPsychiatric Sequelae of Posttraumatic Stress Disorder in Women
Breslau, N. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830130087016 · Cited by 563 · see citing works
Huusom, L. D., Nj, S., Pryds, O. A., Whitfield, K., Gluud, C. N., & Brok, J. S. (2010) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2010.02782.x · Cited by 532 · see citing works
Measurement in nursing research
Waltz, C. F., Strickland, O. L., & Lenz, E. R. (1984) · Medical Entomology and Zoology · Cited by 465 · see citing works
Measurement in Nursing Research
Marrone, S. R. (1992) · AORN Journal · doi:10.1016/s0001-2092(07)69465-4 · Cited by 457 · see citing works
The epidemiology of posttraumatic stress disorder: what is the extent of the problem?
Breslau, N. (2001) · PubMed · Cited by 370 · see citing works
Bollini, P., Pampallona, S., Wanner, P., & Kupelnick, B. (2009) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.10.018 · Cited by 342 · see citing works
McFarlane, J. (1992) · JAMA · doi:10.1001/jama.267.23.3176 · Cited by 336 · see citing works
Pace, T. W. W., & Heim, C. M. (2011) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2010.10.003 · Cited by 321 · see citing works
A guide to guidelines for the treatment of PTSD and related conditions
Forbes, D., Creamer, M., Bisson, J. I., Cohen, J. A., Crow, B. E., Foa, E. B., Friedman, M. J., Keane, T. M., Kudler, H. S., & Ursano, R. J. (2010) · Journal of Traumatic Stress · doi:10.1002/jts.20565 · Cited by 307 · see citing works
Late-Preterm Birth and Its Association With Cognitive and Socioemotional Outcomes at 6 Years of Age
Talge, N. M., Holzman, C., Wang, J., Lucia, V. C., Gardiner, J. C., & Breslau, N. (2010) · PEDIATRICS · doi:10.1542/peds.2010-1536 · Cited by 275 · see citing works
Myer, L., Stein, D. J., Grimsrud, A., Seedat, S., & Williams, D. R. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.01.025 · Cited by 265 · see citing works
Kaminer, D., Grimsrud, A., Myer, L., Stein, D. J., & Williams, D. R. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.07.023 · Cited by 245 · see citing works
Seng, J. S., Low, L. K., Sperlich, M., Ronis, D. L., & Liberzon, I. (2009) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e3181b8f8a2 · Cited by 229 · see citing works
Self-citationClass, Q. A., Lichtenstein, P., Långström, N., & D'Onofrio, B. M. (2011) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31820a62ce · Cited by 211 · see citing works
Research agenda for preterm birth: Recommendations from the March of Dimes
Green, N., Damus, K. H., Simpson, J. L., Iams, J. D., Reece, E. A., Hobel, C. J., Merkatz, I. R., Greene, M. F., & Schwarz, R. H. (2005) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2005.02.106 · Cited by 208 · see citing works
Exposure to Hurricane Katrina, Post-traumatic Stress Disorder and Birth Outcomes
Xiong, X., Harville, E. W., Buekens, P. M., Mattison, D. R., Elkind-Hirsch, K. E., & Pridjian, G. C. (2008) · The American Journal of the Medical Sciences · doi:10.1097/maj.0b013e318180f21c · Cited by 205 · see citing works
Posttraumatic Stress Disorder and Pregnancy Complications
Seng, J. S., OAKLEY, D. J., SAMPSELLE, C. M., KILLION, C., GRAHAM-BERMANN, S., & Liberzon, I. (2001) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(00)01097-8 · Cited by 201 · see citing works
Self-citationPost-traumatic stress disorder: The role of trauma, pre-existing psychiatric disorders, and gender
Hapke, U., Schumann, A., Rumpf, H.-J., John, U., & Meyer, C. (2006) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-006-0654-6 · Cited by 201 · see citing works
Cortisol levels in pregnancy as a psychobiological predictor for birth weight
Bolten, M. I., Wurmser, H., Buske-Kirschbaum, A., Papoušek, M., Pirke, K., & Hellhammer, D. H. (2010) · Archives of Women s Mental Health · doi:10.1007/s00737-010-0183-1 · Cited by 190 · see citing works
Beck, L. F., Morrow, B., Lipscomb, L. E., Johnson, C. H., Gaffield, M. E., Rogers, M., & Gilbert, B. C. (2002) · PubMed · Cited by 189 · see citing works
Dansky, B. S., Saladin, M. E., Brady, K. T., Kilpatrick, D. G., & Resnick, H. S. (1995) · International Journal of the Addictions · doi:10.3109/10826089509055829 · Cited by 185 · see citing works
The World Trade Center Disaster and Intrauterine Growth Restriction
Berkowitz, G. S., Wolff, M. S., Janevic, T. M., Holzman, I. R., Yehuda, R., & Landrigan, P. J. (2003) · JAMA · doi:10.1001/jama.290.5.595-b · Cited by 146 · see citing works
Engel, S. M., Berkowitz, G. S., Wolff, M. S., & Yehuda, R. (2005) · Paediatric and Perinatal Epidemiology · doi:10.1111/j.1365-3016.2005.00676.x · Cited by 145 · see citing works
Sequelae of abuseHealth effects of childhood sexual abuse, domestic battering, and rape
Bohn, D. K., & HOLZ, K. (1996) · Journal of Nurse-Midwifery · doi:10.1016/s0091-2182(96)80012-7 · Cited by 143 · see citing works
Leeners, B., Richter‐Appelt, H., Imthurn, B., & Rath, W. H. (2006) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2005.11.006 · Cited by 138 · see citing works
Psychiatric morbidity and pregnancy outcome in a disaster area of Taiwan 921 earthquake
Chang, H., Chang, T., Lin, T., & Kuo, S. (2002) · Psychiatry and Clinical Neurosciences · doi:10.1046/j.1440-1819.2002.00948.x · Cited by 137 · see citing works
Effects of posttraumatic stress disorder on pregnancy outcomes
Rogal, S. S., Poschman, K., Belanger, K. D., Howell, H. B., Smith, M. V., Medina, J., & Yonkers, K. A. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.01.003 · Cited by 134 · see citing works
Premature Termination of Clinical Trials
Brass, E. P. (2003) · JAMA · doi:10.1001/jama.290.5.595-a · Cited by 132 · see citing works
Inslicht, S. S., Marmar, C. R., Neylan, T. C., Metzler, T. J., Hart, S. L., Otte, C., McCaslin, S. E., Larkin, G. L., Hyman, K. B., & Baum, A. E. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2006.03.007 · Cited by 118 · see citing works
Rosen, D., Seng, J. S., Tolman, R. M., & Mallinger, G. (2007) · Journal of Interpersonal Violence · doi:10.1177/0886260507304551 · Cited by 113 · see citing works
Self-citationExploring posttraumatic stress disorder symptom profile among pregnant women
Seng, J. S., Rauch, S. A. M., Resnick, H. S., Reed, C. D., King, A. P. J., Low, L. K., McPherson, M. D., Muzik, M., Abelson, J. L., & Liberzon, I. (2010) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/0167482x.2010.486453 · Cited by 113 · see citing works
Self-citationDisparity in posttraumatic stress disorder diagnosis among African American pregnant women
Seng, J. S., Kohn‐Wood, L. P., McPherson, M. D., & Sperlich, M. I. (2011) · Archives of Women s Mental Health · doi:10.1007/s00737-011-0218-2 · Cited by 112 · see citing works
Self-citationPosttraumatic Stress Disorder and Pregnancy Health: Preliminary Update and Implications
Morland, L. A., Goebert, D. A., Onoye, J., Frattarelli, L. C., Derauf, C., Herbst, M., Matsu, C. R., & Friedman, M. J. (2007) · Psychosomatics · doi:10.1176/appi.psy.48.4.304 · Cited by 107 · see citing works
Birth Outcomes Among Offspring of Women Exposed to the September 11, 2001, Terrorist Attacks
Lipkind, H. S., Curry, A. E., Huynh, M., Thorpe, L. E., & Matte, T. (2010) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e3181f2f6a2 · Cited by 75 · see citing works
Increased Cortisol in Women With Intimate Partner Violence‐Related Posttraumatic Stress Disorder
Inslicht, S. S., Marmar, C. R., Neylan, T. C., Metzler, T. J., Hart, S. L., Otte, C., McCaslin, S. E., Larkin, G. L., Hyman, K. B., & Baum, A. E. (2006) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1364.035 · Cited by 72 · see citing works
Differential pathways to preterm delivery for sexually abused and comparison women
Noll, J. G., Schulkin, J., Trickett, P. K., Susman, E. J., Breech, L., & Putnam, F. W. (2007) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsm046 · Cited by 71 · see citing works
A CONCEPTUAL FRAMEWORK FOR RESEARCH ON LIFETIME VIOLENCE, POSTTRAUMATIC STRESS, AND CHILDBEARING
Seng, J. S. (2002) · Journal of Midwifery & Women s Health · doi:10.1016/s1526-9523(02)00275-1 · Cited by 58 · see citing works
Self-citationSurvivor Moms: Women’s Stories of Birthing, Mothering and Healing after Sexual Abuse
Simkin, P. (2010) · Birth · doi:10.1111/j.1523-536x.2009.00384_1.x · Cited by 35 · see citing works
Seng, J. S. (2010) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2010.496075 · Cited by 31 · see citing works
Self-citationSurvivor Moms: Women's Stories of Birthing, Mothering and Healing after Sexual Abuse
(2009) · Journal of Midwifery & Women s Health · doi:10.1016/j.jmwh.2009.04.005 · Cited by 29 · see citing works
Reliability of a Perinatal Outcomes Measure: The Optimality Index–US
Seng, J. S., Mugisha, E., & Miller, J. M. (2008) · Journal of Midwifery & Women s Health · doi:10.1016/j.jmwh.2007.09.006 · Cited by 17 · see citing works
Self-citationSohlström, A., Carlsson‐Skwirut, C., Bang, P., Brismar, K., & Uvnäs‐Moberg, K. (1999) · Pediatric Research · doi:10.1203/00006450-199909000-00016 · Cited by 9 · see citing works
ACOG educational bulletin: Adult Manifestation of Childhood Sexual Abuse
(2001) · International Journal of Gynecology & Obstetrics · doi:10.1016/s0020-7292(01)00491-x · Cited by 7 · see citing works
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- [44]American College of Obstetricians & Gynecologists Domestic violence. ACOG Education Bulletin: number 257 1999 The College Washington, DC
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Blackmore, E. R., Putnam, F. W., Pressman, E. K., Rubinow, D. R., Putnam, K. T., Matthieu, M. M., Gilchrist, M. A., Jones, I., & O'Connor, T. G. (2016) · Journal of Traumatic Stress · doi:10.1002/jts.22095 · Cited by 40 · see citing works
Baas, M. A. M., Stramrood, C. A. I., Dijksman, L. M., de Jongh, A., & van Pampus, M. G. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1293315 · Cited by 31 · see citing works
Nillni, Y. I., Baul, T. D., Paul, E., Godfrey, L. B., Sloan, D. M., & Valentine, S. E. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2023.04.013 · Cited by 24 · see citing works
- Authors
- Seng, J., Low, L., Sperlich, M., Ronis, D., & Liberzon, I.
- Affiliations
- University of Michigan (US)
- Wayne State University (US)
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2011-07-27
- Volume
- 118
- Issue
- 11
- Pages
- 1329-1339
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- PMC
- PMC3171570
- OpenAlex
- W2137378820
- Cited by
- 157
- References
- 57
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 10 · 2022: 9 · 2021: 17 · 2020: 10 · 2019: 8 · 2018: 8 · 2017: 22 · 2016: 11 · 2015: 15 · 2014: 13 · 2013: 12 · 2012: 6
- FWCI
- 10.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Nursing Research (R01NR008767, NR008767)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- post-traumatic stress disorder, child abuse, birth weight, gestational age, perinatal outcomes, African American women, prenatal care, nulliparous women, socioeconomic status
- MeSH terms
- Adolescent, Adult, Birth Weight, Female, Gestational Age, Humans, Pregnancy, Pregnancy Outcome, Prospective Studies, Spouse Abuse, Stress Disorders, Post-Traumatic, Linear Models, Adult Survivors of Child Abuse, Young Adult
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