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| Name | Class |
|---|---|
| Women's Health Research Institute of British Columbia | OTHER |
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The goal of this observational study is to learn whether early postpartum screening tools can predict the development of childbirth-related post-traumatic stress symptoms in individuals who undergo unplanned cesarean delivery.
The main questions it aims to answer are:
Participants will:
Researchers will evaluate whether early screening scores are associated with later symptoms of childbirth-related PTSD and postpartum depression, and will assess the feasibility and acceptability of implementing routine inpatient screening for psychological birth trauma.
Childbirth-related post-traumatic stress disorder (CB-PTSD) is increasingly recognized as a contributor to maternal morbidity and is more common among individuals who undergo unplanned cesarean delivery. Early identification of individuals at risk for CB-PTSD could allow timely referral to mental health support; however, screening for psychological birth trauma is not routinely performed in the immediate postpartum period.
This prospective observational cohort study will evaluate whether early postpartum screening tools can predict later PTSD symptoms following unplanned cesarean delivery. Participants will complete the Peritraumatic Distress Inventory (PDI), the City Birth Trauma Scale - Short Form (CityBiTS-SF), and the Edinburgh Postnatal Depression Scale (EPDS) within 24-48 hours postpartum. Follow-up surveys at 6 weeks and 3 months postpartum will assess PTSD symptoms using the PTSD Checklist for DSM-5 (PCL-5) and depressive symptoms using the EPDS.
The primary objective is to determine whether early postpartum screening scores on the PDI and CityBiTS-SF predict childbirth-related PTSD symptoms at 6 weeks postpartum. Secondary analyses will evaluate diagnostic performance of these tools, associations with postpartum depressive symptoms, and the feasibility of implementing routine postpartum screening for psychological birth trauma.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Unplanned Cesarean Delivery Cohort | Postpartum individuals aged 19 years or older who undergo an unplanned cesarean delivery at BC Women's Hospital & Health Centre and consent to participate in the study. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Postpartum Psychological Screening | Other | Participants complete validated screening questionnaires 24-48 hours postpartum, including the Peritraumatic Distress Inventory, City Birth Trauma Scale - Short Form, and Edinburgh Postnatal Depression Scale (EPDS). Follow-up surveys at 6 weeks and 3 months postpartum include the PTSD Checklist for DSM-5, EPDS, and City Birth Trauma Scale - Long Form |
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity of the Peritraumatic Distress Inventory (PDI ≥15) for Predicting Childbirth-Related PTSD Symptoms at 6 Weeks Postpartum | Sensitivity of a Peritraumatic Distress Inventory score ≥15 obtained 24-48 hours postpartum for predicting childbirth-related post-traumatic stress symptoms at 6 weeks postpartum, defined as a PTSD Checklist for DSM-5 (PCL-5) score ≥33. | 6 weeks postpartum |
| Sensitivity of the City Birth Trauma Scale - Short Form (CityBiTS-SF ≥4) for Predicting Childbirth-Related PTSD Symptoms at 6 Weeks Postpartum | Sensitivity of a City Birth Trauma Scale - Short Form score ≥4 obtained 24-48 hours postpartum for predicting childbirth-related post-traumatic stress symptoms at 6 weeks postpartum, defined as a PTSD Checklist for DSM-5 (PCL-5) score ≥33. | 6 weeks postpartum |
| Measure | Description | Time Frame |
|---|---|---|
| Diagnostic Accuracy of Early Postpartum Peritraumatic Distress Inventory (PDI) Screening for Childbirth-Related PTSD Symptoms | Specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and area under the receiver operating characteristic curve for a Peritraumatic Distress Inventory score ≥15 obtained 24-48 hours postpartum for predicting childbirth-related PTSD symptoms defined as PTSD Checklist for DSM-5 (PCL-5) score ≥33. |
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Inclusion Criteria:
Exclusion Criteria:
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The study population consists of postpartum individuals who undergo an unplanned cesarean delivery at BC Women's Hospital & Health Centre, a tertiary maternity care center in Vancouver, Canada.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Katherine Seligman, MD | Contact | 604-875-2158 | katie.seligman@cw.bc.ca |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| BC Women's Hospital and Health Centre | Recruiting | Vancouver | British Columbia | V6H 3N1 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 8443054 | Background | Dopfer R, Niethammer D. Report on the international workshop of the Kind Philipp Foundation on late effects after bone marrow transplantation in childhood malignancies. Pediatr Hematol Oncol. 1993 Jan-Mar;10(1):63-84. doi: 10.3109/08880019309016530. | |
| 38122842 | Background | Dekel S, Papadakis JE, Quagliarini B, Pham CT, Pacheco-Barrios K, Hughes F, Jagodnik KM, Nandru R. Preventing posttraumatic stress disorder following childbirth: a systematic review and meta-analysis. Am J Obstet Gynecol. 2024 Jun;230(6):610-641.e14. doi: 10.1016/j.ajog.2023.12.013. Epub 2023 Dec 18. |
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|
| 6 weeks & 3 Months Postpartum |
| Diagnostic Accuracy of Early Postpartum City Birth Trauma Scale - Short Form (CityBiTS-SF) Screening for Childbirth-Related PTSD Symptoms | Specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and area under the receiver operating characteristic curve for a City Birth Trauma Scale - Short Form score ≥4 obtained 24-48 hours postpartum for predicting childbirth-related PTSD symptoms defined as PTSD Checklist for DSM-5 (PCL-5) score ≥33. | 6 weeks & 3 Months Postpartum |
| Association Between Early Peritraumatic Distress Inventory Scores and Postpartum Depression Symptoms | Correlation and predictive accuracy of Peritraumatic Distress Inventory scores obtained 24-48 hours postpartum for identifying clinically significant postpartum depressive symptoms, defined as Edinburgh Postnatal Depression Scale score ≥13. | 6 weeks & 3 Months Postpartum |
| Feasibility of Inpatient Postpartum Psychological Screening | Feasibility will be evaluated by screening completion rates, administration time, and the proportion of eligible participants who complete psychological screening questionnaires within 24-48 hours postpartum. | 24-48 hours postpartum |
| Participant Acceptability of Postpartum Psychological Screening | Acceptability will be assessed using structured participant feedback surveys evaluating comfort with screening, perceived relevance, and perceived burden of completing screening questionnaires. | 24-48 hours postpartum |
| Themes Associated with Traumatic Birth Experiences | Qualitative thematic analysis of open-ended participant responses describing distressing or traumatic aspects of childbirth. Themes will be identified using structured coding methods and summarized using frequency counts. | 24-48 hours postpartum |
| 38233316 | Background | Horsch A, Garthus-Niegel S, Ayers S, Chandra P, Hartmann K, Vaisbuch E, Lalor J. Childbirth-related posttraumatic stress disorder: definition, risk factors, pathophysiology, diagnosis, prevention, and treatment. Am J Obstet Gynecol. 2024 Mar;230(3S):S1116-S1127. doi: 10.1016/j.ajog.2023.09.089. Epub 2024 Jan 9. |
| 38071102 | Background | Ayers S, Horsch A, Garthus-Niegel S, Nieuwenhuijze M, Bogaerts A, Hartmann K, Karlsdottir SI, Oosterman M, Tecirli G, Turner JD, Lalor J; COST Action CA18211. Traumatic birth and childbirth-related post-traumatic stress disorder: International expert consensus recommendations for practice, policy, and research. Women Birth. 2024 Mar;37(2):362-367. doi: 10.1016/j.wombi.2023.11.006. Epub 2023 Dec 8. |
| ID | Term |
|---|---|
| D013313 | Stress Disorders, Post-Traumatic |
| D019052 | Depression, Postpartum |
| ID | Term |
|---|---|
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |
| D011644 | Puerperal Disorders |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
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