Title page
The incidence of post-traumatic stress disorder (PTSD) following
traumatic childbirth: a systematic review and meta-analysis
Xiao-lu Lai, BSN,a,b Hai-qi Li,cLe-peng Zhou, BSN,a,b Yan Liao,
BEng,d Shi Wu Wen, PhD,d,e Ri-hua
Xie, PhD a,b
a School of Nursing, Southern Medical University,
Guangzhou, China.
b Department of Nursing, Foshan Institute of Fetal
Medicine, Foshan Women and Children Hospital Affiliated to Southern
Medical University, Foshan, China.
c Department of Medical Laboratory Science, Hebei
Medical University, Shijiazhuang, China.
d Ottawa Hospital Research Institute, Ottawa, ON,
Canada.
e School of Epidemiology and Public Health, Faculty of
Medicine, University of Ottawa, Ottawa, ON, Canada.
Correspondence:
Ri-Hua Xie, PhD
Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital
Affiliated to Southern Medical University, 11 Renminxi Road, Foshan,
Guangdong, 528000, China.
Phone: +86 189 2869 7126
E-mail: xierihua928@hotmail.com
Background Birth trauma may be a risk factor for postpartum
post-traumatic stress disorder (PTSD). However, no systematic review on
postpartum PTSD in women with traumatic childbirth has been reported.
Objective This study aimed to estimate the incidence of PTSD
following traumatic childbirth through systematic review and
meta-analysis.
Search strategy Six databases (CINAHL, PsycINFO, Embase,
PubMed, CNKI and Wanfang) were searched from inception to 28 February
2022.
Selection criteria Cohort studies and cross-sectional studies
related to the incidence of PTSD following traumatic childbirth were
included.
Data collection and analysis Two reviewers independently
conducted studies selection, quality evaluation of studies, and data
extraction. The Random-effects meta-analysis was conducted to derive the
pooled incidence using Stata 16.0 software.
Main results A total of nine studies with 1,823 women
experienced traumatic birth were included. Of them, 353 were identified
as PTSD. The pooled incidence of PTSD after traumatic childbirth was
19.2% (95%CI: 11.9%~26.5%). Subgroup analyses showed
that the incidence of PTSD varied with traumatic birth/PTSD assessment
scales and time, and type of study participants. Meta-regression
analyses indicated that the study country was a significant source of
heterogeneity, and the sample size birth trauma/PTSD were potential
predictors of incidence of PTSD after a traumatic birth. Sensitivity
analysis by deleting one study at a time yielded similar results.
Conclusions The incidence of PTSD in women with traumatic
childbirth is about 19%, which is much higher than that in general
postpartum population.
Keywords post-traumatic stress disorder, incidence, traumatic
childbirth, postpartum, meta-analysis
Tweetable abstract This systematic review findings show the
incidence of PTSD in women with traumatic childbirth is much higher than
that in general postpartum population.