ArticlePloS one2021
Trait anxiety and unplanned delivery mode enhance the risk for childbirth-related post-traumatic stress disorder symptoms in women with and without risk of preterm birth: A multi sample path analysis.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01974531 (Psychological Distress & Stress in Parents With Preterm infants-a Prospective Study on Risk and Protective Psychobiological Aspects), which is not on this map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Psychological Distress & Stress in Parents With Preterm infants-a Prospective Study on Risk and Protective Psychobiological Aspects
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Preventing posttraumatic stress disorder following childbirth: a systematic review and meta-analysis.American journal of obstetrics and gynecology · 2024Pooled it
- Posttraumatic stress disorder prevalence and childbirth: update meta-analysis after the introduction of the DSM-5 and COVID-19 pandemic.Archives of women's mental health · 2024Pooled it
- Key factors associated with the development of childbirth-related acute and posttraumatic stress symptoms: a prospective cohort study on the role of pain-related constructs.European journal of psychotraumatology · 2026Article
- Fathers at risk: Effects of threatened and actual preterm birth on the course of paternal peripartum depression and anxiety.PloS one · 2026Observational
- Posttraumatic stress disorder in the preconception period: an open pilot feasibility study.Maternal health, neonatology and perinatology · 2025Article
- Post-Traumatic Stress Symptoms Following Childbirth: A Contribution to the Psychometric Evaluation of the Greek Version of the Traumatic Event Scale (TES) (Version B).Healthcare (Basel, Switzerland) · 2025Article
- The mediating role of coping style in the relationship between fear of childbirth and psychological birth trauma among natural childbirth women in China: a structural equation model analysis.BMC pregnancy and childbirth · 2025Article
- Exploring traumatic childbirth: Associations between obstetric violence indicators and perinatal posttraumatic stress.PloS one · 2025Article
- Psychological and social factors influencing mother-child bonding in the first year after birth: a model for promoting infant and maternal well-being.Frontiers in psychology · 2025Article
- Perinatal posttraumatic stress disorder as a predictor of mother-child bonding quality 8 months after childbirth: a longitudinal study.BMC pregnancy and childbirth · 2024Article
- The Social Context of Pregnancy, Respectful Maternity Care, Biomarkers of Weathering, and Postpartum Mental Health Inequities: A Scoping Review.International journal of environmental research and public health · 2024Article
- Incidence of Perinatal Post-Traumatic Stress Disorder in Catalonia: An Observational Study of Protective and Risk Factors.Healthcare (Basel, Switzerland) · 2024Article
- AI and narrative embeddings detect PTSD following childbirth via birth stories.Scientific reports · 2024Article
- OpenAI's Narrative Embeddings Can Be Used for Detecting Post-Traumatic Stress Following Childbirth Via Birth Stories.Research square · 2024Article
- A Systematic Review of Interventions for Prevention and Treatment of Post-Traumatic Stress Disorder Following Childbirth.medRxiv : the preprint server for health sciences · 2023Article
- Identifying women with postdelivery posttraumatic stress disorder using natural language processing of personal childbirth narratives.American journal of obstetrics & gynecology MFM · 2023Article
- Genital perception and vulvar appearance after childbirth: a cohort analysis of genital body image and sexuality.Archives of gynecology and obstetrics · 2023Article
- Longitudinal patterns of the relation between anxiety, depression and posttraumatic stress disorder among postpartum women with and without maternal morbidities in Northwest Ethiopia: a cross-lagged autoregressive structural equation modelling.Archives of public health = Archives belges de sante publique · 2022Article
- Identifying Women with Post-Delivery Posttraumatic Stress Disorder using Natural Language Processing of Personal Childbirth Narratives.medRxiv : the preprint server for health sciences · 2022Article
- Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Childbirth-related post-traumatic stress disorder (CB-PTSD) occurs in 3-7% of all pregnancies and about 35% of women after preterm birth (PTB) meet the criteria for acute stress reaction. Known risk factors are trait anxiety and pain intensity, whereas planned delivery mode, medical support, and positive childbirth experience are protective factors. It has not yet been investigated whether the effects of anxiety and delivery mode are mediated by other factors, and whether a PTB-risk alters these relationships. 284 women were investigated antepartum and six weeks postpartum (risk-group with preterm birth (RG-PB) N = 95, risk-group with term birth (RG-TB) N = 99, and control group (CG) N = 90). CB-PTSD symptoms and anxiety were measured using standardized psychological questionnaires. Pain intensity, medical support, and childbirth experience were assessed by single items. Delivery modes were subdivided into planned vs. unplanned delivery modes. Group differences were examined using MANOVA. To examine direct and indirect effects on CB-PTSD symptoms, a multi-sample path analysis was performed. Rates of PTS were highest in the RG-PB = 11.58% (RG-TB = 7.01%, CG = 1.1%). MANOVA revealed higher values of CB-PTSD symptoms and pain intensity in RG-PB compared to RG-TB and CG. Women with planned delivery mode reported a more positive birth experience. Path modeling revealed a good model fit. Explained variance was highest in RG-PB (R2 = 44.7%). Direct enhancing effects of trait anxiety and indirect reducing effects of planned delivery mode on CB-PTSD symptoms were observed in all groups. In both risk groups, CB-PTSD symptoms were indirectly reduced via support by medical staff and positive childbirth experience, while trait anxiety indirectly enhanced CB-PTSD symptoms via pain intensity in the CG. Especially in the RG-PB, a positive birth experience serves as protective factor against CB-PTSD symptoms. Therefore, our data highlights the importance of involving patients in the decision process even under stressful birth conditions and the need for psychological support antepartum, mainly in patients with PTB-risk and anxious traits. Trial registration number: NCT01974531 (ClinicalTrials.gov identifier).
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