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Master Thesis

État de stress post-traumatique maternel à 8 semaines d’un accouchement par voie basse : fréquence et facteurs de risque

Abstract : Introduction: The prevalence of post-traumatic stress disorder (PTSD) following vaginal delivery and its risk factors are uncertain in standard obstetrical risk population. The aims of our study were to determine the prevalence and identify characteristics associated with a PTSD 8 weeks after vaginal delivery in a standard obstetrical risk population. Methods : Ancillary cohort study of the TRAAP1 randomized controlled trial, conducted in fifteen French maternity units between 2015 and 2016. Women older than 18 years old and who underwent vaginal delivery after 35 weeks of gestation were enrolled. PTSD symptoms and PTSD diagnostic were assessed 8 weeks after childbirth by two validated self-report questionnaires (IES-R and TES). The associations between potential risk factors and PTSD were analyzed by multivariate logistic or linear modelling depending on the nature of the dependent variable, after multiple imputation for missing data. Results: Prevalences of PTSD symptoms and PTSD diagnosis were respectively 4.3% (119/2740) and 1.6% (44/2740) with the IES-R, and 4.9% (137/2785) and 0.4% (9/2080) with the TES. Characteristics associated with higher risk of PTSD were vulnerability factors (notably young age, North African country and psychiatric comorbidities) and obstetric risk factors (notably induction of labor (aOR 1.49 95%CI 1.00-2.23), postpartum hemorrhage ≥ 1000mL (aOR 2.02 95%CI 1.02-4.24) and bad memories of delivery at day 2 postpartum (aOR 4.45 95%CI 2.38-8.33) with the IES-R). These results were close with the TES scale. Conclusion: PTSD following childbirth is not rare after vaginal delivery in a standard obstetrical risk population. Presence of obstetric risk factors and bad memories following childbirth may help to detect women with high risk of PTSD in order to propose immediate intervention.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03153698
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Submitted on : Friday, February 26, 2021 - 4:06:32 PM
Last modification on : Saturday, February 27, 2021 - 3:10:59 AM

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Alizée Froeliger. État de stress post-traumatique maternel à 8 semaines d’un accouchement par voie basse : fréquence et facteurs de risque. Santé publique et épidémiologie. 2020. ⟨dumas-03153698⟩

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