STRAWB2 (Stress and Wellbeing After Childbirth): a randomised controlled trial of targeted self-help materials to prevent post-traumatic stress disorder following childbirth.
BJOG
; 127(7): 886-896, 2020 Jun.
Article
em En
| MEDLINE
| ID: mdl-32034849
ABSTRACT
OBJECTIVES:
To test whether providing psychological self-help materials would significantly lower the incidence of post-traumatic stress disorder (PTSD) at 6-12 weeks postnatally.DESIGN:
Open-label randomised controlled trial, with blinded outcome assessment.SETTING:
Community midwifery services in two National Health Service (NHS) trusts in the North West. SAMPLE A cohort of 2419 women receiving normal NHS postnatal care.METHODS:
Midwives screened women for traumatic birth experience; 678 women who screened positively (28.1%) were randomly allocated to self-help with usual care (n = 336) or to usual care alone (n = 342). The self-help materials were a leaflet and online film designed to prevent the development of PTSD after trauma exposure through explaining how to manage early psychological responses. MAIN OUTCOMEMEASURE:
The primary outcome was a composite of diagnostic and subdiagnostic PTSD at 6-12 weeks postnatally using the gold-standard Clinician-Administered PTSD Scale (CAPS-5) interview.RESULTS:
Of the 678 women correctly randomised plus the nine women randomised in error, 478 (70.5%) were followed up. Diagnostic or subdiagnostic PTSD rates at follow-up did not differ between groups who received self-help (26.7%, 65/243) or usual care alone (26.2%, 64/244) (intention-to-treatanalysis:
RR 1.02, 95% CI 0.68-1.53). Findings remained consistent in the per-protocol analysis (RR 1.04, 95% CI 0.85-1.27). Women viewed the materials very positively. There were no adverse effects. Health economic micro-costing indicated implementation would be very low cost.CONCLUSIONS:
Many women experience a traumatic birth and risk developing PTSD, but self-help strategies without professional support are insufficient and should not be routinely introduced. TWEETABLE ABSTRACT Self-help information alone does not reduce the number of women developing PTSD after a traumatic childbirth.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Folhetos
/
Qualidade de Vida
/
Transtornos de Estresse Pós-Traumáticos
/
Parto
/
Intervenção Baseada em Internet
/
Complicações do Trabalho de Parto
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Qualitative_research
Aspecto:
Patient_preference
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
BJOG
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Reino Unido