ArticlePloS one2022
Longitudinal mediation analysis of the factors associated with trajectories of posttraumatic stress disorder symptoms among postpartum women in Northwest Ethiopia: Application of the Karlson-Holm-Breen (KHB) method.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 16 papers, 1 of them a synthesis that pooled it.
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16 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- The epidemiology of maternal mental health in Africa: a systematic review.Archives of women's mental health · 2025Pooled it
- Aligning attitudes and actions: experience of extreme weather events raises environmental concerns and pro-environmental behaviors of residents.Frontiers in public health · 2026Article
- Post-traumatic stress disorder symptoms in high-risk pregnant women during the perinatal period: a longitudinal study.Frontiers in psychology · 2026Article
- Systolic blood pressure time in target range within 24 h and in-hospital death of critically ill patients and the role of ventricular arrhythmias: a MIMIC-IV analysis with external validation in the eICU-CRD database.European journal of medical research · 2025Article
- Adaptation of a PTSD intervention for use in primary care in a low-income country: The Brief Relaxation, Education And Trauma HEaling intervention for Ethiopia (BREATHE Ethiopia).SSM. Mental health · 2025Article
- The direct and indirect factors of health related quality of life of postpartum women using structural equation modelling.Scientific reports · 2025Article
- Article
- Exploring traumatic childbirth: Associations between obstetric violence indicators and perinatal posttraumatic stress.PloS one · 2025Article
- A nomogram for predicting postpartum post-traumatic stress disorder: a prospective cohort study.BMC psychiatry · 2024Article
- Prevalence of perinatal post-traumatic stress disorder (PTSD) in low-income and middle-income countries: a systematic review and meta-analysis.BMJ public health · 2024Article
- Family concerns and relationship problems in anxious pregnant women and their associations with postnatal functional disability in Pakistan.Journal of psychosomatic research · 2024Article
- Prevalence of postpartum post-traumatic stress disorder and associated factors among postnatal mothers in West Arsi zone, South West Ethiopia, 2024: a community-based cross-sectional study.Frontiers in psychiatry · 2024Article
- A structural equation modelling of the direct and indirect factors associated with functional status over time as measured by WHODAS-32 items among postpartum women in Northwest Ethiopia.Archives of public health = Archives belges de sante publique · 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
- Adverse Childhood Experiences and Cardiovascular Risk among Young Adults: Findings from the 2019 Behavioral Risk Factor Surveillance System.International journal of environmental research and public health · 2022Article
- BMI mediates the association of family medical history with self-reported hypertension and diabetes among older adults: Evidence from baseline wave of the longitudinal aging study in India.SSM - population health · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn recent years, literatures identified childbirth as a potentially traumatic experience resulting in posttraumatic stress disorder (PTSD), with 19.7 to 45.5% of women perceiving their childbirth as traumatic. A substantial variation in PTSD symptoms has been also indicated among women who experience a traumatic childbirth. However, there has been no research that has systematically investigated these patterns and their underlying determinants in postpartum women in Ethiopia.
objectiveThe aim of this study was to investigate the trajectories of PTSD symptoms and mediating relationships of variables associated with it among postpartum women in Northwest Ethiopia.
methodsA total of 775 women were recruited after childbirth and were followed at the 6th, 12th and 18th week of postpartum period during October, 2020 -March, 2021. A group-based trajectory modeling and mediation analysis using KHB method were carried out using Stata version 16 software in order to determine the trajectories of PTSD symptoms and mediation percentage of each mediator on the trajectories of PTSD symptoms.
resultsFour distinct trajectories of postpartum posttraumatic stress disorder symptoms were identified. Perceived traumatic childbirth, fear of childbirth, depression, anxiety, psychological violence, higher WHODAS 2.0 total score, multigravidity, stressful life events of health risk, relational problems and income instability were found to be predictors of PTSD with recovery and chronic PTSD trajectory group membership. Depression and anxiety not only were strongly related to trajectories of PTSD symptoms directly but also mediated much of the effect of the other factors on trajectories of PTSD symptoms. In contrast, multiparity and higher mental quality of life scores were protective of belonging to the PTSD with recovery and chronic PTSD trajectory group membership.
conclusionWomen with symptoms of depression, anxiety, fear of childbirth and perceived traumatic childbirth were at increased risk of belonging to recovered and chronic PTSD trajectories. Postnatal screening and treatment of depression and anxiety may contribute to decrease PTSD symptoms of women in the postpartum period. Providing adequate information about birth procedures and response to mothers' needs during childbirth and training of health care providers to be mindful of factors that contribute to negative appraisals of childbirth are essential to reduce fear of childbirth and traumatic childbirth so as to prevent PTSD symptoms in the postpartum period.
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