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Maternal PTSD, major depressive episode increased preterm birth risk

Maternal diagnoses of posttraumatic stress disorder and a major depressive episode increased the risk of preterm birth, independent of antidepressant and benzodiazepine use, according to new study findings published in JAMA Psychiatry.

Kimberly Ann Yonkers, MD, of the Yale School of Medicine, and colleagues evaluated 2,654 pregnant women before 17 weeks’ gestation to determine the risk of preterm births associated with PTSD, major depressive episodes, and the use of antidepressants and benzodiazepine medications.

Kimberly Ann Yonkers

Overall, 129 participants had symptoms of PTSD consistent with a DSM-IV diagnosis, including 78 in the first trimester, 43 in the second and 33 in the third.

There was a positive association with serotonin reuptake inhibitors and preterm birth (OR=1.55; 95% CI, 1.02-2.36), as well as preterm birth history (OR=4.37; 95% CI, 3.02-6.33). However, a negative association was found between preterm birth and mother’s age (25-34 years vs. 35 years or older; OR=0.62; 95% CI, 0.45-0.85).

There was a four times increased risk of preterm birth among participants with symptoms of PTSD and a major depressive episode compared with participants without symptoms (OR=4.08; 95% CI, 1.27-13.15).

Weak relationships were also found between risk of preterm birth and PTSD symptoms or previous exposure to trauma.

“Birth outcomes can be optimized if women are treated before embarking on pregnancy,” Yonkers told Healio.com. “Treatment may include either psychotherapy or pharmacotherapy. The healthier a woman is when she enters pregnancy, the better chances of an optimal birth outcome.” — by Amber Cox

Disclosure: See the study for a full list of researchers’ financial disclosures.