Trajectories of perinatal post-traumatic stress disorder scores in association with child's behaviour at 12 months.

Abstract

Background: Perinatal mental health is fundamental to a healthy society. The aim of this study was to describe the trajectories of women's posttraumatic stress disorder (PTSD) symptoms during the perinatal period to assess their association with child behaviour problems at 12 months.

Methods: We designed an observational longitudinal study. Women were recruited through social media posting during the Coronavirus Disease 2019 (COVID-19) pandemic Italian national lockdown from 8 April to 4 May 2020, and contacted again at 6 and 12 months after the expected delivery date, collecting PTSD scores each time. Behavioural outcome of the children were measured at 12 months postpartum. Inclusion criteria were residence in Italy, age over 18 years, and fluency in Italian.

Results: A total of 327 mother-child dyads were eligible for inclusion in the study. Cluster analysis suggested five groups of maternal PTSD trajectories: a very low and stable (VL) group, 2 groups with decreasing PTSD symptoms over time (one high and decreasing (H-), one low and decreasing (L-)), and 2 groups with worsening PTSD symptom trajectories (one high and increasing (H+), one low and increasing (L+)). The H+ and H- clusters had significantly higher risks (+58% and + 76% for H+ and H-, respectively) of total child behavioural problems compared with the VL cluster, higher for internalising problems.

Conclusions: Although many women had PTSD scores below the cut-off, children of mothers with elevated prenatal symptoms remain at significant risk of behavioural problems. Longitudinal modelling of perinatal PTSD symptoms is warranted for sensitive two-generation risk detection.