Systematic Review of Perinatal PTSD and Child Outcomes

Maternal post-traumatic stress disorder (PTSD) during the perinatal period—the time from the beginning of pregnancy until 1 year following childbirth—may have a negative impact on child outcomes. A systematic review, published in the Journal of Affective Disorders, synthesized and critically evaluated quantitative research on the association between perinatal maternal PTSD and postpartum birth outcomes, child development, and mother-infant relationships.

A total of 26 papers that reported on 21 studies were included in the review. The studies reviewed were heterogeneous in nature, with poor to medium scores in methodologic quality. Methodologic limitations of the studies were related to insufficient sample sizes, the use of invalidated measures, and limited external validity.

Child outcomes were grouped according to the following categories: postnatal birth outcomes (fetal growth, low birth weight, gestational duration, preterm birth, head circumference, breastfeeding); child development (cognitive development, sleeping and eating difficulties, infant salivary cortisol levels); and mother-infant relationships (maternal interactional behavior, infant interactional behavior, and parent-infant bond).

Results of the study demonstrated that postpartum PTSD is associated with low birth weight and lower rates of breastfeeding. Evidence was contradictory with respect to an association between maternal PTSD and preterm birth, fetal growth, head circumference, mother-infant interaction, the mother-infant relationship, and child development. Because the association between maternal PTSD and infant salivary cortisol levels, and between maternal PTSD and eating and sleeping difficulties, are based on single studies, these findings require replication before any conclusions can be drawn.

The investigators concluded that perinatal maternal PTSD is linked to certain negative child outcomes. Early screening for PTSD during the perinatal period is suggested, along with referral for effective treatment, if warranted. Future studies should use larger sample sizes, validated and reliable interviews for assessing PTSD, validated measures for evaluating child outcomes, and a prospective design.

Reference

Cook N, Ayers S, Horsch A. Maternal posttraumatic stress disorder during the perinatal period and child outcomes: a systematic review. J Affect Disord. 2017;225:18-31.