Prenatal wellbeing of mothers, their partners, and couples: a cross-sectional descriptive study.

BACKGROUND: Prenatal posttraumatic stress symptoms (PTSS), fear of childbirth (FOC), and depressive symptoms have been related to various negative effects during pregnancy, childbirth, and in the postnatal period. This study evaluates the prevalence of PTSS, FOC, depressive symptoms, and health-related quality of life (HRQoL) among pregnant women, their partners, and as couples. METHODS: In a cohort of 3853 volunteered, unselected women at the mean of 17th weeks of pregnancy with 3020 partners, PTSS was evaluated by Impact of Event Scale (IES), FOC by Wijma Delivery Expectancy Questionnaire (W-DEQ-A), depressive symptoms by Edinburgh Postnatal Depression Scale (EPDS), and HRQoL by 15D instrument. RESULTS: PTSS (IES score ≥ 33) was identified among 20.2% of the women, 13.4% of the partners, and 3.4% of the couples. Altogether, 5.9% of the women, but only 0.3% of the partners, and 0.04% of the couples experienced symptoms suggestive of phobic FOC (W-DEQ A ≥ 100). Respectively, 7.6% of the women, 1.8% of the partners, and 0.4% of the couples reported depressive symptoms (EPDS ≥ 13). Nulliparous women and partners without previous children experienced FOC more often than those with previous children, but there was no difference in PTSS, depressive symptoms, or HRQoL. Women's mean 15D score was lower than partners' and that of age- and gender-standardized general population, while partners' mean 15D score was higher than that of age- and gender-standardized general population. Women whose partners reported PTSS, phobic FOC, or depressive symptoms, often had the same symptoms (22.3%, 14.3%, and 20.4%, respectively). CONCLUSIONS: PTSS were common in both women and partners, as well as in couples. FOC and depressive symptoms were common in women but uncommon in partners, thus they rarely occurred simultaneously in couples. However, special attention should be paid to a pregnant woman whose partner experiences any of these symptoms.

How do different childbirth experience scales predict childbirth-related posttraumatic stress symptoms and disorder?

PURPOSE: Post-traumatic stress disorder (PTSD) after childbirth causes severe and lasting effects. Screening of childbirth experience may expedite early PTSD recognition. Systematic reviews have not provided consensus on how and when to measure childbirth experience and the clinical implications of such measurements. We aimed to identify a reliable and simple scale for screening the childbirth experience with minimum risk of missing PTSD. MATERIALS AND METHODS: This cohort study evaluated the childbirth experience of 1527 unselected women with Wijma Delivery Experience Questionnaire (W-DEQ-B), Delivery Satisfaction Scale (DSS), and Visual Analogue Scale (VAS). VAS was measured first <1 week (VAS1) and then, together with the other scales, a few months after childbirth (VAS2). The scales' ability to identify PTSD (measured with Traumatic Event Scale) was evaluated and compared with receiver operating characteristic (ROC) analysis. Diagnostic accuracy and clinical usefulness were used to suggest cutoff values for scales. RESULTS: W-DEQ-B showed highest recognition of partial or full PTSD (area under the ROC curve 0.96 in W-DEQ-B, 0.92 in VAS2, 0.91 in DSS and 0.82 in VAS1). CONCLUSIONS: All included scales recognized partial or full PTSD well. Although W-DEQ-B performed best, VAS (measured twice) with cutoff value of 50 mm is most suitable for screening in clinical circumstances.