Cent Eur J Nurs Midw 2025, 16(1):2085-2093 | DOI: 10.15452/cejnm.2025.16.0001
Examining the connection between perceived stress and post-traumatic stress in women who experienced a traumatic childbirth
- 1 RISE-Health, Nursing School of Porto, Porto, Portugal
- 2 William James Center for Research, ISPA – Instituto Universitário, Lisboa, Portugal
- 3 Faculty of Nursing, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
- 4 Department of Psychology, Faculty of Social Sciences, Vytautas Magnus University, Kaunas, Lithuania
- 5 Department of Surgical Specialties, Biochemistry and Immunology, University of Malaga, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Plataforma BIONAND), Research Group in Maternal-Fetal Medicine, Epigenetics, Women’s Diseases and Reproductive Health, Spain
- 6 Midwifery Department, Faculty of Health Sciences, Mersin University, Yenişehir, Mersin, Turkey
- 7 Zübeyde Hanım Faculty of Health Sciences, Niğde Ömer Halisdemir University, Niğde, Turkey
- 8 Department of Psychology, Faculty of Language, History and Geography, Ankara University, Ankara, Turkey
- 9 School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
- 10 Santo António Local Health Unit, EPE, Porto, Portugal
- 11 Maternal, Parental and Infant Nutrition & Nurture research unit, School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom
Aim: This study aimed to: (1) explore post-traumatic stress disorder symptoms in relation to sociodemographic, obstetric, and childbirth trauma factors; (2) assess the association between perceived stress levels and post-traumatic stress disorder symptoms; and (3) analyze how the duration of perceived stress affects post-traumatic stress disorder.
Design: A cross-sectional study.
Methods: Data were collected via an online survey, including demographic and obstetric information, traumatic childbirth events, post-traumatic stress disorder symptoms, and perceived stress levels and duration in the postpartum period. The study was conducted with 202 women who self-identified as having experienced a traumatic childbirth.
Results: Post-traumatic stress disorder scores did not differ significantly by most sociodemographic or obstetric factors, but cesarean delivery was linked to higher post-traumatic stress disorder scores compared to vaginal delivery with forceps or vacuum extraction, mediated by increased perceived stress. Perceived stress levels showed a significant positive association with all post-traumatic stress disorder dimensions. Stress duration significantly was related to total post-traumatic stress disorder scores, with longer stress being associated with greater severity of symptoms.
Conclusion: Cesarean delivery and prolonged, elevated stress during childbirth are key risk factors for post-traumatic stress disorder symptoms, highlighting the need for targeted postpartum mental health interventions.
Klíčová slova: childbirth trauma, perceived stress, post-traumatic stress disorder, woman
Vloženo: 5. srpen 2024; Revidováno: 22. prosinec 2024; Přijato: 8. leden 2025; Zveřejněno: 6. březen 2025 Zobrazit citaci
ACS | AIP | APA | ASA | Harvard | Chicago | Chicago Notes | IEEE | ISO690 | MLA | NLM | Turabian | Vancouver |
Reference
- American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (Vol. 5). American Psychiatric Association Washington, DC.
Přejít k původnímu zdroji...
- Andersen, L. B., Melvaer, L. B., Videbech, P., Lamont, R. F., & Joergensen, J. S. (2012). Risk factors for developing post-traumatic stress disorder following childbirth: a systematic review. Acta Obstetricia et Gynecologica Scandinavica, 91(11), 1261-1272. https://doi.org/10.1111/j.1600-0412.2012.01476.x
Přejít k původnímu zdroji...
Přejít na PubMed...
- Ayers, S. (2004). Delivery as a traumatic event: prevalence, risk factors, and treatment for postnatal posttraumatic stress disorder. Clinical Obstetrics and Gynecology, 47(3), 552-567. https://doi.org/10.1097/01.grf.0000129919.00756.9c
Přejít k původnímu zdroji...
Přejít na PubMed...
- Ayers, S., Bond, R., Bertullies, S., & Wijma, K. (2016). The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychological Medicine, 46(6), 1121-1134. https://doi.org/10.1017/S0033291715002706
Přejít k původnímu zdroji...
Přejít na PubMed...
- Brandao, T., Brites, R., Nunes, O., & Hipolito, J. (2020). Posttraumatic growth after childbirth in women: a systematic review. Journal of Clinical Psychology in Medical Settings, 27, 318-330. https://doi.org/10.1007/s10880-020-09720-w
Přejít k původnímu zdroji...
Přejít na PubMed...
- Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396. https://doi.org/10.2307/2136404
Přejít k původnímu zdroji...
- Creedy, D. K., Shochet, I. M., & Horsfall, J. (2000). Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth, 27(2), 104-111. https://doi.org/10.1046/j.1523-536x.2000.00104.x
Přejít k původnímu zdroji...
Přejít na PubMed...
- Daviu, N., Bruchas, M. R., Moghaddam, B., Sandi, C., & Beyeler, A. (2019). Neurobiological links between stress and anxiety. Neurobiology of Stress, 11, 100191. https://doi.org/10.1016/j.ynstr.2019.100191
Přejít k původnímu zdroji...
Přejít na PubMed...
- Dikmen-Yildiz, P., Ayers, S., & Phillips, L. (2018). Longitudinal trajectories of post-traumatic stress disorder (PTSD) after birth and associated risk factors. Journal of Affective Disorders, 229, 377-385. https://doi.org/10.1016/j.jad.2017.12.074
Přejít k původnímu zdroji...
Přejít na PubMed...
- Ertan, D., Hingray, C., Burlacu, E., Sterlé, A., & El-Hage, W. (2021). Post-traumatic stress disorder following childbirth. BMC Psychiatry, 21(1), 155. https://doi.org/10.1186/s12888-021-03158-6
Přejít k původnímu zdroji...
Přejít na PubMed...
- Grekin, R., OʼHara, M. W., & Brock, R. L. (2021). A model of risk for perinatal posttraumatic stress symptoms. Archives of Womenʼs Mental Health, 24(2), 259-270. https://doi.org/10.1007/s00737-020-01068-2
Přejít k původnímu zdroji...
Přejít na PubMed...
- Hayes, A. F., Montoya, A. K., & Rockwood, N. J. (2017). The analysis of mechanisms and their contingencies: PROCESS versus structural equation modeling. Australasian Marketing Journal, 25(1), 76-81. https://doi.org/10.1016/j.ausmj.2017.02.001
Přejít k původnímu zdroji...
- Heyne, C.-S., Kazmierczak, M., Souday, R., Horesh, D., Lambregtse-van den Berg, M., Weigl, T., Horsch, A., Oosterman, M., Dikmen-Yildiz, P., & Garthus-Niegel, S. (2022). Prevalence and risk factors of birth-related posttraumatic stress among parents: A comparative systematic review and meta-analysis. Clinical Psychology Review, 94, 102157. https://doi.org/10.1016/j.cpr.2022.102157
Přejít k původnímu zdroji...
Přejít na PubMed...
- Isbİr, G. G., İncİ, F., Bektaş, M., Yildiz, P. D., & Ayers, S. (2016). Risk factors associated with post-traumatic stress symptoms following childbirth in Turkey. Midwifery, 41, 96-103. https://doi.org/10.1016/j.midw.2016.07.016
Přejít k původnímu zdroji...
Přejít na PubMed...
- Kjerulff, K. H., Attanasio, L. B., Sznajder, K. K., & Brubaker, L. H. (2021). A prospective cohort study of post-traumatic stress disorder and maternal-infant bonding after first childbirth. Journal of Psychosomatic Research, 144, 110424. https://doi.org/10.1016/j.jpsychores.2021.110424
Přejít k původnímu zdroji...
Přejít na PubMed...
- Kleber, R. J. (2019). Trauma and public mental health: a focused review. Frontiers in Psychiatry, 10, 451. https://doi.org/10.3389/fpsyt.2019.00451
Přejít k původnímu zdroji...
Přejít na PubMed...
- Lee, D. T., Yip, S., Chiu, H. F., Leung, T. Y., Chan, K. P., Chau, I. O., Leung, H. C., & Chung, T. K. (1998). Detecting postnatal depression in Chinese women: validation of the Chinese version of the Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 172(5), 433-437. https://doi.org/10.1192/bjp.172.5.433
Přejít k původnímu zdroji...
Přejít na PubMed...
- Liu, Y., Zhang, L., Guo, N., & Jiang, H. (2021). Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors. BMC Psychiatry, 21(1), 487. https://doi.org/10.1186/s12888-021-03432-7
Přejít k původnímu zdroji...
Přejít na PubMed...
- Marcelino, D., & Gonçalves, S. P. (2012). Perturbação pós-stress traumático: características psicométricas da versão portuguesa da Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) [Posttraumatic stress disorder: psychometric characteristics of the Portuguese version of Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C)]. Revista Portuguesa de Saúde Pública, 30(1), 71-75. https:/doi.org/10.1016/j.rpsp.2012.03.003
Přejít k původnímu zdroji...
- Mayopoulos, G. A., Ein-Dor, T., Dishy, G. A., Nandru, R., Chan, S. J., Hanley, L. E., Kaimal, A. J., & Dekel, S. (2021). COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. Journal of Affective Disorders, 282, 122-125. https://doi.org/10.1016/j.jad.2020.12.101
Přejít k původnímu zdroji...
Přejít na PubMed...
- Modarres, M., Afrasiabi, S., Rahnama, P., & Montazeri, A. (2012). Prevalence and risk factors of childbirth-related post-traumatic stress symptoms. BMC Pregnancy Childbirth, 12, 88. https://doi.org/10.1186/1471-2393-12-88
Přejít k původnímu zdroji...
Přejít na PubMed...
- Motrico, E., Galán-Luque, T., Rodríguez-Domínguez, C., Gómez-Gómez, I., & Domínguez-Salas, S. (2023). Factors associated with post-traumatic stress symptoms in pregnant and postpartum women. Journal of Womenʼs Health, 32(5), 583-591. https://doi.org/10.1089/jwh.2022.0400
Přejít k původnímu zdroji...
Přejít na PubMed...
- OʼDonovan, A., Alcorn, K. L., Patrick, J. C., Creedy, D. K., Dawe, S., & Devilly, G. J. (2014). Predicting posttraumatic stress disorder after childbirth. Midwifery, 30(8), 935-941. https://doi.org/10.1016/j.midw.2014.03.011
Přejít k původnímu zdroji...
Přejít na PubMed...
- Olza, I., Leahy-Warren, P., Benyamini, Y., Kazmierczak, M., Karlsdottir, S. I., Spyridou, A., Crespo-Mirasol, E., Takács, L., Hall, P. J., Murphy, M., Jonsdottir, S. S., Downe, S., & Nieuwenhuijze, M. J. (2018). Women's psychological experiences of physiological childbirth: a meta-synthesis. BMJ Open, 8(10), e020347. https://doi.org/10.1136/bmjopen-2017-020347
Přejít k původnímu zdroji...
Přejít na PubMed...
- Ostacoli, L., Cosma, S., Bevilacqua, F., Berchialla, P., Bovetti, M., Carosso, A. R., Malandrone, F., Carletto, S., & Benedetto, C. (2020). Psychosocial factors associated with postpartum psychological distress during the Covid-19 pandemic: a cross sectional study. BMC Pregnancy Childbirth, 20(1), 703. https://doi.org/10.1186/s12884-020-03399-5
Přejít k původnímu zdroji...
Přejít na PubMed...
- Patterson, J., Hollins Martin, C., & Karatzias, T. (2019). PTSD post-childbirth: a systematic review of womenʼs and midwivesʼ subjective experiences of care provider interaction. Journal of Reproductive and Infant Psychology, 37(1), 56-83. https://doi.org/10.1080/02646838.2018.1504285
Přejít k původnímu zdroji...
Přejít na PubMed...
- Racine, N., Plamondon, A., Hentges, R., Tough, S., & Madigan, S. (2019). Dynamic and bidirectional associations between maternal stress, anxiety, and social support: The critical role of partner and family support. Journal of Affective Disorders, 252, 19-24. https://doi.org/10.1016/j.jad.2019.03.083
Přejít k původnímu zdroji...
Přejít na PubMed...
- Razurel, C., Kaiser, B., Sellenet, C., & Epiney, M. (2013). Relation between perceived stress, social support, and coping strategies and maternal well-being: a review of the literature. Women Health, 53(1), 74-99. https://doi.org/10.1080/03630242.2012.732681
Přejít k původnímu zdroji...
Přejít na PubMed...
- Robitzsch, A. (2020). Why ordinal variables can (almost) always be treated as continuous variables: clarifying assumptions of robust continuous and ordinal factor analysis estimation methods. Frontiers in Education, 5, 589965. https://doi.org/10.3389/feduc.2020.589965
Přejít k původnímu zdroji...
- Rodríguez-Almagro, J., Hernández-Martínez, A., Rodríguez-Almagro, D., Quirós-García, J. M., Martínez-Galiano, J. M., & Gómez-Salgado, J. (2019). Womenʼs perceptions of living a traumatic childbirth experience and factors related to a birth experience. International Journal of Environmental Research and Public Health, 16(9), 1654. https://doi.org/10.3390/ijerph16091654
Přejít k původnímu zdroji...
Přejít na PubMed...
- Sawyer, A., Ayers, S., Young, D., Bradley, R., & Smith, H. (2012). Posttraumatic growth after childbirth: a prospective study. Psychology & Health, 27(3), 362-377. https://doi.org/10.1080/08870446.2011.578745
Přejít k původnímu zdroji...
Přejít na PubMed...
- Schmidt, E.-M., Décieux, F., Zartler, U., & Schnor, C. (2023). What makes a good mother? Two decades of research reflecting social norms of motherhood. Journal of Family Theory & Review, 15(1), 57-77. https://doi.org/https://doi.org/10.1111/jftr.12488
Přejít k původnímu zdroji...
Přejít na PubMed...
- Sharp, M., Huber, N., Ward, L. G., & Dolbier, C. (2021). NICU-Specific Stress Following traumatic childbirth and its relationship with posttraumatic stress. Journal of Perinatal & Neonatal Nursing, 35(1), 57-67. https://doi.org/10.1097/jpn.0000000000000543
Přejít k původnímu zdroji...
Přejít na PubMed...
- Shorey, S., Downe, S., Chua, J. Y. X., Byrne, S. O., Fobelets, M., & Lalor, J. G. (2023). Effectiveness of psychological interventions to improve the mental well-being of parents who have experienced traumatic childbirth: a systematic review and meta-analysis. Trauma Violence Abuse, 24(3), 1238-1253. https://doi.org/10.1177/15248380211060808
Přejít k původnímu zdroji...
Přejít na PubMed...
- Shuman, C. J., Morgan, M. E., Pareddy, N., Chiangong, J., Veliz, P., Peahl, A., & Dalton, V. (2022). Associations among postpartum posttraumatic stress disorder symptoms and COVID-19 Pandemic-related stressors. Journal of Midwifery & Womenʼs Health, 67(5), 626-634. https://doi.org/10.1111/jmwh.13399
Přejít k původnímu zdroji...
Přejít na PubMed...
- Slade, P., Murphy, A., & Hayden, E. (2022). Identifying post-traumatic stress disorder after childbirth. BMJ, 377, e067659. https://doi.org/10.1136/bmj-2021-067659
Přejít k původnímu zdroji...
Přejít na PubMed...
- Türkmen, H., Yalniz Dilcen, H., & Akin, B. (2020). The effect of labor comfort on traumatic childbirth perception, post-traumatic stress disorder, and breastfeeding. Breastfeeding Medicine, 15(12), 779-788. https://doi.org/10.1089/bfm.2020.0138
Přejít k původnímu zdroji...
Přejít na PubMed...
- von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2014). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. International Journal of Surgery, 12(12), 1495-1499. https://doi.org/10.1016/j.ijsu.2014.07.013
Přejít k původnímu zdroji...
Přejít na PubMed...
- Weathers, F., Litz, B., Herman, D., Huska, J. A., & Keane, T. (1993). The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. Annual Convention of the International Society for Traumatic Stress Studies.
- Welcome, M. O., & Mastorakis, N. E. (2020). Stress-induced blood brain barrier disruption: Molecular mechanisms and signaling pathways. Pharmacological Research, 157, 104769. https://doi.org/10.1016/j.phrs.2020.104769
Přejít k původnímu zdroji...
Přejít na PubMed...
- Yehuda, R. (2004). Risk and resilience in posttraumatic stress disorder. Journal of Clinical Psychiatry, 65 Suppl 1, 29-36.
Tento článek je publikován v režimu tzv. otevřeného přístupu k vědeckým informacím (Open Access), který je distribuován pod licencí Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), která umožňuje nekomerční distribuci, reprodukci a změny, pokud je původní dílo řádně ocitováno. Není povolena distribuce, reprodukce nebo změna, která není v souladu s podmínkami této licence.