A systematic review on the assessment of pregnancy-specific psychological trauma during pregnancy: A call to action

Abstract

Objective

Psychological trauma negatively impacts maternal and infant health during the perinatal period. A history of traumatic experiences related to previous pregnancies and births (termed pregnancy-specific psychological trauma or PSPT) increases the risk of a host of psychological disorders. It can impede women's/the pregnant individual's relationship with the healthcare system and their developing child. There are, however, no guidelines or agreed-upon validated screening measures to assess PSPT during the perinatal period. To build a knowledge base to develop future measure(s) of PSPT, we conducted a systematic review to understand how and when PSPT has been measured during pregnancy.

Data sources

Searches were run in July 2021 on the following databases: Ovid MEDLINE (In‐Process & Other Non‐Indexed Citations and Ovid MEDLINE 1946 to Present), Ovid EMBASE (1974 to present), Scopus, Web of Science, PsycInfo, and Cochrane. Updated searches and reference searching/snow-balling were conducted in September 2023.

Study eligibility criteria

The search strategy included all appropriate controlled vocabulary and keywords for psychological trauma and pregnancy.

Methods

This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Two independent researchers screened abstracts and, subsequently, full-texts of abstracts for appropriateness, with conflicts resolved via a third independent reviewer. A secondary analysis was performed on studies measuring PSPT during pregnancy.

Results

Of the 576 studies examining psychological trauma in pregnancy, only 15.8% (n=91) had a measure of PSPT. Of these 91 studies, 53 used a measure designed by the research team to assess PSPT. Critically, none of the measurements used screened for PSPT comprehensively.

Conclusion

It is time to screen for and study PSPT in all perinatal individuals. Recognition of PSPT should promote trauma-informed care delivery by obstetrics and neonatology/pediatric teams during the perinatal period.