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Women with PTSD and major depressive disorder are at a higher risk for preterm b

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Women with both are at a 4-fold increased risk of preterm birth

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Post traumatic stress disorder (PTSD) occurs in about 8% of pregnant women. Stressful conditions, including PTSD are inconsistently linked to preterm birth. Psychotropic treatment has been frequently associated with preterm birth. Identifying whether the psychiatric illness or its treatment is independently associated with preterm birth may help clinicians and patients when making management decisions, according to new study.

In this new study Dr. Kimberly Ann Yonkers, MD, Professor of Psychiatry and of Obstetrics, Gynecology, and Reproductive Sciences; Director, Center for Well-being of Women and Mothers of the Yale School of Medicine, New Haven, Connecticut and colleagues had set out to determine whether a likely diagnosis of PTSD or antidepressant and benzodiazepine treatment during pregnancy is associated with risk of preterm birth. The research team had speculated that pregnant women who likely had PTSD and women receiving antidepressant or anxiolytic treatment would be more likely to experience preterm birth.

The study included 2,654 women recruited before 17 completed weeks of pregnancy from 137 obstetrical practices in Connecticut and Western Massachusetts. Likely psychiatric diagnoses were achieved by giving the Composite International Diagnostic Interview and the Modified PTSD Symptom Scale and all participants were interviewed on medication usage.

The results showed higher rates of preterm birth among women with PTSD. Among the women, 129 had consistent PTSD symptoms. Pregnant women who likely had both conditions had a four-fold increased risk of preterm birth. For each point increase on the Modified PTSD Symptom Scale, the risk of preterm birth increased by 1% to 2%. The odds of preterm birth are high for women who used a serotonin reuptake inhibitor (1.02-2.36%) and women who used a benzodiazepine medication (0.98-4.03%).

The researchers write “Women with likely diagnoses of both PTSD and a major depressive episode are at a 4-fold increased risk of preterm birth; this risk is greater than and independent of, antidepressant and benzodiazepine use and is not simply a function of mood or anxiety symptoms.”

This study is published online in JAMA Psychiatry

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