Complex Mental Health Sequelae of Psychological Trauma Among Women in Prenatal Care

Pregnancy is a critical time to identify and address maternal mental health problems, for the health of both mother and child. Pregnant women with histories of exposure to interpersonal psychological trauma may experience a range of mental health problems including but not limited to posttraumatic stress disorder (PTSD). In a community sample of 1,581 pregnant women, 25% reported symptoms consistent with at least one of six syndromes, including PTSD, major depressive disorder, generalized anxiety disorder, or clinically significant dissociation, somatization, or affect dysregulation. Six subgroups with distinct mental health problem profiles were identified by cluster analysis. Controlling for sociodemographic risk factors, women with histories of interpersonal trauma were overrepresented in four subgroups characterized by: (1) PTSD comorbid with depression (childhood sexual abuse); (2) PTSD comorbid with affect/interpersonal dysregulation (childhood physical or emotional abuse); (3) somatization (adult abuse); and (4) generalized anxiety disorder (foster/adoptive placement). Findings suggest risk relationships warranting further study between different types of interpersonal trauma exposure and psychiatric outcomes in pregnant women, including PTSD with two types of comorbidity.