The Involvement of Neonatal Intensive Care Unit and Other Perinatal Factors in Postpartum PTSD After Cesarean Section

	Admission to the NICU
	No Admission to the NICU	Perinatal Stress/Breathing Difficulty/Infection/IUGR	Prematurity

	M	M	M	F	df	p	η²
PTSD	6.18a	20.64b	21.24b	46.64	2	p < .001	.388
Intrusion/Re-experiencing	1.68a	5.75b	7.18b	56.31	2	p < .001	.195
Avoidance	.72a	2.26b	2.20b	31.58	2	p < .001	.119
Negative Alterations in Cognitions and Mood	2.34a	7.04b	6.71b	32.28	2	p < .001	.122
Alterations in Arousal and Reactivity	1.44a	5.58b	5.14b	41.31	2	p < .001	.151

Results of multiple regression analyses with presence of PTSD as a dependent variable.

	b	S.E.	β	t	p
(Constant)	.19	.09		2.15	.032
Pathology of Gestation
Thrombophilia/Hyperemesis	.27	.42	.02	.63	ns
Placenta Previa Type4/Abruption/Bleeding	.55	.28	.07	1.98	.049
Diabetes	.21	.17	.05	1.26	ns
Cervical Insufficiency	.80	.41	.07	1.94	ns
Infection	.60	.49	.05	1.24	ns
Premature Contractions	.84	.40	.08	2.07	.039
Cause of C-section
Abnormal Foetal Position	.11	.16	.03	.65	ns
Twins/IVF Gestation	.09	.22	.01	.39	ns
Mother's Desire	.19	.22	.03	.86	ns
Heavy Medical History/Previous Gynecological History/Preeclampsia	.49	.23	.09	2.13	.034
Failure of Labour to Progress	−.05	.19	−.01	−.26	ns
Abnormal Heart Rate/Pathological NST/Premature Rupture of Membrane/Premature Contractions/Infection	.61	.21	.14	2.87	.004
Criterion A1 & A2
Life of Child in Danger	.50	.22	.12	2.24	.025
Life of Mother in Danger	.32	.34	.04	.95	ns
Both Lives in Danger	.69	.37	.10	1.89	ns
Complications Involving Child	.77	.25	.15	3.11	.002
Complications Involving Mother	.52	.35	.07	1.49	ns
Complications Involving Both (Child and Mother)	1.19	.46	.12	2.56	.011
Traumatic C-section	1.19	.12	.41	9.55	p < .001
Reasons for the NICU
NICU – Perinatal Stress/Breathing Difficulty/Infection/IUGR	.02	.22	.01	.08	ns
NICU – Prematurity	.57	.25	.12	2.29	.022

Demographic, perinatal and mental health variables in relationship to PTSD

Demographic Variables	f/M	rf/SD	p
Age	32.58	6.15	.445^a
Residence			.921^b
City	373	79.5
Village	96	20.5
Total	469	100.0
Nationality			.447^b
Greek	423	90.2
Other	46	9.8
Total	469	100.0
Family Status			.239^b
Single /Divorced	7	1.5
In Relationship/Engaged	47	10.0
Married	415	88.5
Total	469	100.0
Educational Level			.193^b
Primary School	39	8.3
Junior High	30	6.4
High School	196	41.8
University	170	36.2
MSc/PhD	34	7.2
Total	469	100.0
Occupation			.181^b
Public/Private Sector	136	29.0
Freelance	67	14.3
Healthcare Professional	38	8.1
Educators	43	9.2
Household	123	26.2
Unemployed	62	13.2
Total	469	100.0
Financial Status			.014^b
Low	136	29.0
Middle	320	68.2
High	13	2.8
Total	469	100.0
Perinatal Health Variables
Parity			.013^b
0	202	43.1
1 birth	177	37.7
≥ 2 births	90	19.2
Total	469	100.0
Type of Previous Labour			p < .001^b
No Previous Labour	204	43.5
Vaginal	41	8.7
C-section	224	47.8
Total/Missing	469	100.0
Kind of Conception			.490^b
Normal	429	91.5
In Vitro Fertilization (IVF)	40	8.5
Total	469	100.0
Gynecologic History			.012^b
No	421	89.8
Yes	48	10.2
Total	469	100.0
Gestational Week	37.76	2.10	p < .001^b
< 37	70	14.9
≥ 37	399	85.1
Total	469	100.0
Type of C-section			p < .001^b
Emergency	181	38.6
Elective	288	61.4
Total	469	100.0
Cause of C-section			p < .001^b
Previous C-section/Premature Rupture of Membranes/Premature Contractions in a Previous C-section/Placenta Previa	203	43.3
Abnormal Foetal Position	66	14.1
Twins/IVF gestation	30	6.4
Mother's Desire	30	6.4
Heavy Medical History/Myopia/Previous Gynecological History/Preeclampsia	35	7.5
Failure of Labour to Progress	43	9.2
Abnormal Heart Rate/Pathological NST/Doppler/Premature Rupture of Membranes/Premature Contractions/Infection	62	13.2
Total	469	100.0
C-section Complications			p < .001^b
No	434	92.5
Yes	35	7.5
Total	469	100.0
Birth Expectations/Satisfaction			p < .001^b
No	245	52.2
Yes	224	47.8
Total	469	100.0
Admission to Neonatal Intensive Care Unit (NICU)			p < .001^b
No Admission to the NICU	367	78.3
Perinatal Stress/Breathing Difficulty/Infection/IUGR/Other Disorders	53	11.3
Prematurity	49	10.4
Total	469	100.0
Breastfeeding			p < .001^b
No	153	32.6
Yes	316	67.4
Total	469	100.0
Mental Health Variables
Psychiatric History			p < .001^b
No	411	87.6
Yes	58	12.4
Total	469	100.0
Partner Support			p < .001^b
No	68	14.5
Yes	401	85.5
Total	469	100.0
Traumatic C-section			p < .001^b
No	230	49.0
Yes	239	51.0
Total	469	100.0
Criterion A1 – Was your life or your child's life in danger?			p < .001^b
No	368	78.5
Yes, of My Child	63	13.4
Yes, Mine	17	3.6
Yes, of Both of Us	21	4.5
Total	469	100.0
Criterion A2 – Any complications involving you or your child?			p < .001^b
No	400	85.3
Yes, My Child	43	9.2
Yes, Me	16	3.4
Yes, Both of Us	10	2.1
Total	469	100.0
Diagnosis			p < .001^b
No Diagnosis	378	80.6
Partial PTSD	36	7.7
PTSD	55	11.7
Total	469	100.0
No Admission to the NICU
No Diagnosis	318	86.6
Partial PTSD	33	9.0
PTSD	16	4.4
Total	367	100.0
Perinatal Stress/Breathing Difficulty/Infection/IUGR
No Diagnosis	31	58.5
Partial PTSD	2	3.8
PTSD	20	37.7
Total	53	100.0
Prematurity
No Diagnosis	29	59.2
Partial PTSD	1	2.0
PTSD	19	38.8
Total	49	100.0

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The Involvement of Neonatal Intensive Care Unit and Other Perinatal Factors in Postpartum PTSD After Cesarean Section

Article Category: Original article

Publié en ligne: 03 nov. 2023

Pages: 158 - 167

Reçu: 23 mai 2023

Accepté: 21 sept. 2023

DOI: https://doi.org/10.34763/jmotherandchild.20232701.d-23-00056

Mots clésNeonatal intensive care unit, NICU, postpartum PTSD, birth trauma, cesarean section, hospitalised neonate, traumatic birth experience

© 2023 Eirini Orovou et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

The results of the analyses of variance

Results of multiple regression analyses with presence of PTSD as a dependent variable.

Demographic, perinatal and mental health variables in relationship to PTSD

Mots clés
Neonatal intensive care unit, NICU, postpartum PTSD, birth trauma, cesarean section, hospitalised neonate, traumatic birth experience