"Pregnancy related physical health conditions and postnatal PTSD: the identification of risk factors associated with PTSD severity postpartum” and “Testing a cognitive model in regard to posttraumatic stress disorder following Hyperemesis Gravidarum"

Serrell, Jerrie 2021. "Pregnancy related physical health conditions and postnatal PTSD: the identification of risk factors associated with PTSD severity postpartum” and “Testing a cognitive model in regard to posttraumatic stress disorder following Hyperemesis Gravidarum". ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Objectives: (1) To systematically review the evidence regarding physical health conditions of pregnancy (PHCP) and postpartum PTSD; and (2) to identify risk factors for PTSD severity postpartum. Methods: Quantitative research investigating the association between PHCP and postpartum PTSD was synthesised and critically evaluated in accordance with PRISMA guidance. CINAHL, EMBASE, Medline, and PsycINFO databases were searched between July 2019-October 2020 using specific inclusion/exclusion criteria. Included papers were critically reviewed by two independent reviewers using the relevant Critical Appraisal Skills Program (CASP) checklists or Strengthening the Reporting of Observational studies in Epidemiology (STROBE) assessment tool. Risk factors for PTSD severity postpartum identified in the included studies were categorised in-line with the Ehlers and Clark’s cognitive model of PTSD. Results: Thirteen papers sampling 8172 women were identified, with methodological quality rated between acceptable-to-high. Pregnancy related conditions including abnormally invasive placenta, ectopic pregnancy, hyperemesis gravidarum, peripartum cardiomyopathy and premature rupture of the membranes are associated with elevated rates of PTSD postpartum. Evidence regarding the association between pregnancy related hypertensive disorders and PTSD is mixed. In accordance with Ehlers and Clarke’s cognitive model of PTSD, findings indicate that 12 postpartum PTSD following exposure to a PHCP may evolve as a result of multiple risk factors, and that individual cognitive processing of an event may increase vulnerability to postpartum PTSD. Strengths and Limitations: This is the first systematic review to evaluate quantitative research regarding PHCP and postpartum PTSD. Strengths include the comprehensive search strategy that aligns with the PRISMA guidance and the inclusion of studies that sample women from a broad age range and a variety of countries. Lack of replication and heterogeneity between studies limits comparisons and conclusions. Conclusions: Postpartum PTSD is associated with PHCP. Further investigation with more stringent and homogenous research designs is required, as with the exception of hyperemesis gravidarum and hypertensive disorders of pregnancy, all other associations between pregnancy conditions and postpartum PTSD came from single studies. Enhanced monitoring of women who have been exposed to PHCP during the postnatal period is advisable to detect and ensure adequate support for women at risk of postpartum PTSD.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	22 September 2021
Last Modified:	10 Dec 2022 02:30
URI:	https://orca.cardiff.ac.uk/id/eprint/144049

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