Longitudinal effects of pregnancy on PTSD symptoms in black female participants: Moderation by sexual trauma and progesterone

Black pregnant females experience disproportionately higher rates of post-traumatic stress disorder (PTSD) and associated health complications, which may be exacerbated by exposure to sexual trauma. Hormonal fluctuations during pregnancy, including progesterone, may also play a key role in modulating PTSD symptoms. The current study assessed how PTSD symptoms change over pregnancy and how sexual trauma and progesterone independently impact the trajectory of PTSD symptoms in a sample of under-resourced pregnant Black females. Participants (N = 283) completed up to three interviews assessing PTSD symptoms over pregnancy; the enrollment interview assessed pre-pregnancy trauma history. Progesterone concentrations were measured in a subset of participants (N = 91). Results from linear mixed models showed that PTSD symptoms decreased over the course of pregnancy, Β= -0.34, p<.001, and that sexual trauma exposure was associated with higher initial PTSD symptoms, Β = 12.11, p<.001, and a significant decrease in PTSD symptoms across pregnancy, Β = -0.48, p = .002. Individuals with no sexual trauma exposure did not show significant change in PTSD symptoms across pregnancy, Β =-0.14, p = .207. This pattern was observed for total PTSD symptoms and all symptom clusters. In the subset of participants with progesterone data, higher progesterone levels, relative to gestational age, was associated with a greater decrease in PTSD symptoms over pregnancy, Β =-0.01, p = .049. The current findings indicate that individuals with a history of sexual trauma demonstrate higher levels of PTSD symptoms early in pregnancy and suggest that PTSD symptoms may decrease over pregnancy via increasing progesterone levels.