PTSD and premature babies

Women who have suffered post-traumatic stress disorder (PTSD) are more likely to deliver a baby prematurely when they get pregnant, an American study has found.

The study, published in the journal Obstetrics & Gynecology, looked at data from 2002 to 2012 covering 16,000 births to female veterans – a group more likely than average to have experienced PTSD. It found that having PTSD in the year before delivery increased a woman’s risk of spontaneous premature delivery by 35 percent. (Women who’d had PTSD more than a year previously were no more likely to have a premature delivery than women who’d never had PTSD.)

The researchers looked into the possibility that the premature delivery was caused by other factors such as drug use or other mental health conditions, and found that it wasn’t – in cases where those factors were present, but there was no PTSD, the women were no more likely to have a premature delivery than other women.

Ciaran Phibbs, the Stanford University researcher who carried out the research, said: “The mechanism is biologic. Stress is setting off biologic pathways that are inducing preterm labour. It’s not the other psychiatric conditions or risky behaviours that are driving it.”

What are the implications?

It’s an interesting, tantalising study: it shows that PTSD has real, physical consequences. Premature delivery is a serious problem that can have devastating health outcomes for the baby, but its causes are still poorly understood. Being able to identify one possible mechanism is a big step.

What of women who have suffered PTSD as a result of giving birth and then go on to have another baby? We don’t know if they are also more likely to give birth prematurely. Many women with severe PTSD decide not to have another child – and those who do are perhaps more likely to wait until they have made at least a partial recovery. It would be good to have research into the risks of premature delivery for those women who do get pregnant again.

The ability to identify at least some women who at risk of giving birth prematurely is something health professionals must now take seriously – and if it makes them more alert to the mental health risks associated with pregnancy and birth, then that is all to the good.

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