- •The pooled prevalence of PTSD was 11.2% in Chinese postpartum women, with a highest prevalence within 1 month postpartum.
- •Sample size and measurements were conditional on the prevalence of postpartum posttraumatic stress disorder.
- •No statistical differences were found in variables with study design, setting, region, time-points, and publication year.
- •Screening and intervention programs are needed to reduce exposure to postpartum mental health problems among Chinese women.
The prevalence and risk factors of postpartum posttraumatic stress disorder reported by population-based studies have significantly varied and the data are all collected from regional populations in Mainland China.
To utilize published data to estimate the overall prevalence of postpartum posttraumatic stress disorder and its determinants in Mainland China.
Comprehensively electronic searches were performed across six English databases and three Chinese databases. Random effects of the meta-analysis were performed to evaluate the pooled prevalence of postpartum posttraumatic stress disorder. Meta-regression was performed with the variable of study design, sample size, setting, measures, region, time points, and publication year.
Totaling of nineteen studies was included, with a sample size of 13,231 postpartum women. The pooled prevalence of postpartum posttraumatic stress disorder was 11.2 % in Mainland China, with a higher prevalence at the timepoint within 1 month postpartum (18.1 %). Significant publication bias and heterogeneity were found (I2 = 97.1 %). Sample size and measurements were conditional on the prevalence of postpartum posttraumatic stress disorder. Postpartum depressive symptoms, sleep problems, cesarean section, and low levels of social support were the major risk factors for postpartum posttraumatic stress disorder. While being the one child in the family was the protective factor.
An increasing prevalence of posttraumatic stress disorder within one month postpartum significantly arises awareness to provide screening and more mental health services during this period. Screening programs for postpartum posttraumatic stress disorder are still needed in Mainland China.
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- ACOG Committee Opinion No. 757: Screening for perinatal depression.Obstetrics and Gynecology. 2018; 132: e208-e212https://doi.org/10.1097/AOG.0000000000002927
- A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events.Psychological Medicine. 2010; 40: 1849-1859https://doi.org/10.1017/S0033291709992224
Association, A.P., n.d.Association, A.P., n.d. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. | Therapeutic Recreation Journal [WWW Document]. URL https://js.sagamorepub.com/trj/article/view/5720 (accessed 5.28.22).
- Post-traumatic stress disorder following childbirth: Current issues and recommendations for future research.Journal of Psychosomatic Obstetrics and Gynaecology. 2008; 29: 240-250https://doi.org/10.1080/01674820802034631
- Traumatic childbirth and its aftermath: Is there anything positive?.The Journal of Perinatal Education. 2018; 27: 175-184https://doi.org/10.1891/1058-1243.27.3.175
- Prevalence, evolution, and predictive factors of symptoms of postpartum posttraumatic stress disorder in a French-speaking cohort.Journal of Midwifery & Women's Health. 2022; https://doi.org/10.1111/JMWH.13350
- Effects of an early intervention on maternal post-traumatic stress symptoms and the quality of mother-infant interaction: The case of preterm birth.Infant Behavior & Development. 2014; 37: 624-631https://doi.org/10.1016/J.INFBEH.2014.08.003
- Maternal PTSD following exposure to the Wenchuan earthquake is associated with impaired mental development of children.PloS one. 2017; 12https://doi.org/10.1371/JOURNAL.PONE.0168747
- Detection and prevention of postpartum posttraumatic stress disorder: A call to action.Obstetrics and Gynecology. 2020; 136: 1030-1035https://doi.org/10.1097/AOG.0000000000004093
- Association between perceived birth trauma and postpartum depression: A prospective cohort study in China.International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics. 2022; : 157https://doi.org/10.1002/IJGO.13845
- Risk factors of postpartum posttraumatic stress disorder(Chinese).Journal of Nursing Science. 2021; 36: 29
- Post-traumatic stress disorder after childbirth and the influence of maternity team care during labour and birth: A cohort study.Midwifery. 2016; 32: 87-92https://doi.org/10.1016/J.MIDW.2015.08.010
- The impact of childbirth-related post-traumatic stress on a couple's relationship: A systematic review and meta-synthesis.Journal of Reproductive and Infant Psychology. 2018; 36: 102-115https://doi.org/10.1080/02646838.2017.1397270
- Promote natural birth and reduce the cesarean rate.Beijing Med. 2015; 37 (doi:15932/j.0253-9713.2015.7.001): 613-615
- Bias in meta-analysis detected by a simple, graphical test.BMJ (Clinical Research Edition). 1997; 315: 629-634https://doi.org/10.1136/BMJ.315.7109.629
- Women’s perceptions and experiences of a traumatic birth: A meta-ethnography.Journal of Advanced Nursing. 2010; 66: 2142-2153https://doi.org/10.1111/J.1365-2648.2010.05391.X
- Analysis of related factors of postpartum post-traumatic stress disorder(Chinese).Chinese Journal of Behavioral Medicine and Brain Science. 2019; 28: 1025-1029
- Progress and challenges in maternal health in western China: A countdown to 2015 national case study.The Lancet Global Health. 2017; 5: e523-e536https://doi.org/10.1016/S2214-109X(17)30100-6
- Prevalence and risk factors of postpartum posttraumatic stress disorder: A meta-analysis.Clinical Psychology Review. 2014; 34: 389-401https://doi.org/10.1016/J.CPR.2014.05.003
- Cochrane handbook for systematic reviews of interventions: Cochrane book series.2008https://doi.org/10.1002/9780470712184
- The role of education in maternal depressive symptoms among different ethnic groups: A cross-sectional study in rural western China.Journal of Affective Disorders. 2020; 262: 359-365https://doi.org/10.1016/J.JAD.2019.11.022
- Fertility intentions to have a second or third child under China's three-child policy: A national cross-sectional study.Human Reproduction. 2022; 37: 1907-1918https://doi.org/10.1093/humrep/deac101
- The effects of preterm birth on mother-infant interaction and attachment during the infant's first two years.Acta Obstetricia et Gynecologica Scandinavica. 2012; https://doi.org/10.1111/j.1600-0412.2011.01304.x
- Management of post traumatic stress disorder after childbirth: A review.Journal of Psychosomatic Obstetrics and Gynecology. 2010; 31: 113-122https://doi.org/10.3109/0167482X.2010.503330
- An investigation of postpartum post-traumatic stress disorder after cesarean delivery and its influencing factors(Chinese).Journal of Chinese Physician. 2020; 22https://doi.org/10.3760/CMA.J.CN431274-20190514-00572
- Postpartum depression and postpartum post-traumatic stress disorder: Prevalence and associated factors.BMC Psychiatry. 2021; 21https://doi.org/10.1186/S12888-021-03432-7
- Post-traumatic stress disorder in parturients delivering by caesarean section and the implication of anaesthesia: A prospective cohort study.Health and Quality of Life Outcomes. 2017; 15https://doi.org/10.1186/S12955-017-0692-Y
- Longitudinal mediation analysis of the factors associated with trajectories of posttraumatic stress disorder symptoms among postpartum women in Northwest Ethiopia: Application of the Karlson-Holm-Breen (KHB) method.PloS one. 2022; 17e0266399https://doi.org/10.1371/JOURNAL.PONE.0266399
- Antenatal and postnatal mental health clinical management and service.NICE Guideline, 2014
- Childbirth-related post-traumatic stress disorder in couples: A qualitative study.British Journal of Health Psychology. 2007; 12: 491-509https://doi.org/10.1348/135910706X120627
- Post-traumatic stress disorder following childbirth: Prevalence and contributing factors(Chinese).China Medical University, 2016
- Assessment and interventions for perinatal depression.2nd ed. Registered Nurses’s Association of Ontario, 2018
- Appendix D. Quality assessment forms.2004
- Translation of the Chinese version city birth trauma scale and its application in parturient women(Chinese).Jiangsu University, 2021
- Consensus on maternal mental health management (2019) (Chinese).Chinese Journal of Woman and Child Health Research. 2019; 30: 781-786https://doi.org/10.3969/j.issn.1673-5293.2019.07.001
- Funnel plots for detecting bias in meta-analysis: Guidelines on choice of axis.Journal of Clinical Epidemiology. 2001; 54: 1046-1055https://doi.org/10.1016/S0895-4356(01)00377-8
- An evidence review and model for prevention and treatment of postpartum posttraumatic stress disorder.Nursing for Women's Health. 2015; 19: 504-525https://doi.org/10.1111/1751-486X.12234
- Post-traumatic stress disorder in the perinatal period: A concept analysis.Journal of Clinical Nursing. 2017; 26: 3859-3868https://doi.org/10.1111/JOCN.13800
- A study on relationships between post-traumatic stress prevalence and psychological resilience(Chinese).Nursing Journal of Chinese People's Liberation Army. 2018; 35: 1-7https://doi.org/10.3969/j.issn.1008-9993.2018.16.001
- Relationship between maternal neuroticism and posttraumatic stress disorder in women after postpartum (Chinese).Nursing Journal of Chinese People's Liberation Army. 2020; 37: 51-55https://doi.org/10.3969/j.issn.1008-9993.2020.01.013
- The Newcastle-Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses.(Available from: URL)10.2307/632432)
- Analysis of influencing factors of postpartum post-traumatic stress disorder in women(Chinese).Medical Information. 2020; 33: 139https://doi.org/10.3969/j.issn.1006-1959.2020.14.039
- Study on stress disorder status of 557 delivery women in 42 days after postpartum(Chinese).China Journal of Health Psychology. 2012; 20: 681-683
- Study on the pregnant psychology and their effects on postpartum stress(Chinese).China Journal of Health Psychology. 2012; 20: 841-843
- Positive rate and risk factors of post-traumatic stress disorder symptoms among mothers with hospitalized preterm infant(Chinese).Medical Journal of Wuhan University. 2018; 39: 974-977,981https://doi.org/10.14188/j.1671-8852.2018.0704
- The prevalence and influencing factors of post-traumatic stress disorder in postpartum women(Chinese).Journal of Fujian Medical University (Social Science Edition). 2021; 22: 14-19
- The postpartum mind disorder and its influencing factors (Chinese).Wuhan University, 2019
- Investigation and analysis of maternal psychological stress during COVID-19 epidemic period(Chinese).Shanghai Medical Journal. 2021; 44: 491-495https://doi.org/10.19842/j.cnki.issn.0253-9934.2021.07.009
- The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis.Journal of Affective Disorders. 2017; 208: 634-645https://doi.org/10.1016/J.JAD.2016.10.009
- Pregnant women with posttraumatic stress disorder and risk of preterm birth.JAMA Psychiatry. 2014; 71: 897-904https://doi.org/10.1001/JAMAPSYCHIATRY.2014.558
- The effects of China's universal two-child policy.Lancet (London, England). 2016; 388: 1930-1938https://doi.org/10.1016/S0140-6736(16)31405-2
- Validating the psychometric characteristics of the perinatal posttraumatic stress disorder questionnaire (PPQ) in a Chinese context.Archives of Psychiatric Nursing. 2018; https://doi.org/10.1016/j.apnu.2017.09.016
- Mediating effects of pregnancy stress on social support and postpartum post-traumatic stress disorder in parturient women (Chinese).Chinese Journal of Modern Nursing. 2021; 27: 188-192https://doi.org/10.3760/cma.j.cn115682-20200507-03201
- Current status and influencing factors of post-traumatic stress disorder among 2552 parturients in Shanghai(Chinese).Chinese Journal of Modern Nursing. 2021; 27: 4298-4303https://doi.org/10.3760/cma.j.cn115682-20210412-01615
- Study on the correlation between posttraumatic stress disorder and psychological resilience in pregnant women with possible preterm labor.International Journal of Clinical and Experimental Medicine. 2021; 14: 1693-1702
Published online: April 22, 2023
Accepted: April 18, 2023
Received in revised form: February 18, 2023
Received: September 7, 2022
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