Is PTSD another risk factor for preterm birth?

A history of at least 1 major depressive episode and a diagnosis of posttraumatic stress disorder (PTSD) may increase the risk of preterm birth (PTB) 4-fold, according to a recent study in JAMA Psychiatry.

Researchers at Yale School of Medicine and University of Pennsylvania did a prospective study of 2654 women who been recruited from 137 practices in Connecticut and Western Massachusetts before 17 weeks of pregnancy. Psychiatric diagnoses were identified by administering the Complete International Diagnostic Interview and the Modified PTSD Symptom Scale and medication use data were gathered at participant reviews.

Elevated rates of PTB among women with PTSD were identified with recursive partitioning analysis and splitting the PTSD node further suggested an interaction between PTSD and major depression. Logistic regression analysis confirmed an increased risk of PTB in women who likely had both PTSD and a major depressive episode (odds ratio [OR], 4.08, 95% confidence interval [CI], 1.27-13.15). PTB risk increased by 1% to 2% for each point increase on the Modified PTSD Symptom Scale, which has a range of 0 to 110. It was also high in women who took a serotonin reuptake inhibitor (OR, 1.55, 95% CI, 1.02-2.36) or a benzodiazepine medication (OR, 1.99, 95% CI, 0.98-4.03).

The study authors concluded that women with likely diagnoses of PTSD and a major depressive episode are at a 4-fold increased risk of PTB. This risk is independent of antidepressant and benzodiazepine use.

To get weekly advice for today's Ob/Gyn, subscribe to the Contemporary Ob/Gyn Special Delivery.