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Cross-national risk factors for childbirth-related PTSD: Findings from the INTERSECT study

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dc.contributor.authorHandelzalts, Jonathan E.
dc.contributor.authorAyers, Susan
dc.contributor.authorWebb, Rebecca
dc.contributor.authorConstantinou, Georgina
dc.contributor.authorLucas, Grace
dc.contributor.authorGrollman, Christopher
dc.contributor.authorOhayon, Shay
dc.contributor.authorAwad Sirhan, Natalia
dc.contributor.authorBaird, Kathleen
dc.contributor.authorBaldisserotto, Márcia
dc.contributor.authorBatool, Ramish
dc.contributor.authorBatool, Shahida
dc.contributor.authorCaparros-Gonzalez, Rafael A.
dc.contributor.authorChorwe-Sungani, Genesis
dc.contributor.authorChristoforou, Andri
dc.contributor.authorCoo, Soledad
dc.contributor.authorCosta, Raquel
dc.contributor.authorDikmen-Yildiz, Pelin
dc.contributor.authorĎuríčeková, Barbora
dc.contributor.authorDušová, Bohdana
dc.contributor.authorEnea, Violeta
dc.contributor.authorGarthus-Niegel, Susan
dc.contributor.authorGrundström, Hanna
dc.contributor.authorGureje, Oye
dc.contributor.authorHadjigeorgiou, Eleni
dc.contributor.authorMarie Haga, Silje
dc.contributor.authorHorsch, Antje
dc.contributor.authorIonio, Chiara
dc.contributor.authorJarašiūnaitė-Fedosejeva, Gabija
dc.contributor.authorJomeen, Julie
dc.contributor.authorKazmierczak, Maria
dc.contributor.authorLalor, Joan
dc.contributor.authorMilosavljevic, Maja
dc.contributor.authorNagle, Ursula
dc.contributor.authorNakić Radoš, Sandra
dc.contributor.authorNieminen, Katri
dc.contributor.authorDamilola Oladeji, Bibilola
dc.contributor.authorOsório, Flavia
dc.contributor.authorPawlicka, Paulina
dc.contributor.authorPeled, Yoav
dc.date.accessioned2026-07-24T16:49:36Z
dc.date.available2026-07-24T16:49:36Z
dc.date.issued2025
dc.descriptionTiago Miguel Pinto, Valentine Rattaz, Olga Riklikienė, Julia Schellong, Valgerður Lísa Sigurðardóttir, Narenda Singh Thagunna, Mariza Theme Filha, Zuzana Škodová, Petra Stebelová, Tjasa Stepisnik Perdih, Robert Stewart, Emma Marie Swift, Kristiina Uriko, Zahir Vally, Milica Vezmar, Haya S. Zedan, Maja Žutić and the INTERSECT Consortium
dc.description.abstractBackground: Childbirth-related post-traumatic stress disorder (CB-PTSD) is an underrecognized condition with consequences for mothers and infants. This study aimed to determine risk factors for CB-PTSD symptoms across countries within a stress-diathesis framework, focusing on antenatal, birth-related, and postpartum predictors. Methods: The INTERSECT cross-sectional survey (April 2021-January 2024) included 11,302 women at 6-12 weeks postpartum. The study was carried out across maternity services in 31 countries. Outcomes were CB-PTSD diagnosis, symptom severity, and perceived traumatic birth, assessed with the City Birth Trauma Scale. Multiple risk factors were assessed, including preexisting vulnerability, pregnancy, birth, and infant related factors. All models were adjusted for country-level variation as a random effect. Results: Models explained substantial variance across all outcomes (conditional R2 = 0.53-0.58). Negative birth experience was the strongest predictor (e.g. odds ratio [OR] = 0.82, 95% confidence interval [CI] = 0.80-0.84 for diagnosis). Ongoing maternal complications predicted both CB-PTSD diagnosis and symptoms (e.g. OR = 1.61, 95% CI = 1.41-1.84), and major infant complications were associated with CB-PTSD diagnosis (OR = 1.63, 95% CI = 1.29-2.07). Reports of perceived danger to self or infant (criterion A) were linked to higher CB-PTSD symptoms and traumatic birth ratings (e.g., β =0.25, 95% CI = 0.21-0.29). Other predictors reached significance but showed small effects. Conclusions: Findings support a stress-diathesis framework, showing that while pre-existing vulnerabilities contribute, birth-related stressors exert the strongest influence. Trauma-informed maternity care should prioritize these factors, with attention to women's appraisals of birth.
dc.description.versionVersión publicada
dc.format.extent9 p.
dc.identifier.citationHandelzalts, J. E., Ayers, S., Webb, R., Constantinou, G., Lucas, G., Grollman, C., Ohayon, S., Awad Sirhan, N., Baird, K., Baldisserotto, M., Batool, R., Batool, S., Caparros-Gonzalez, R. A., Chorwe-Sungani, G., Christoforou, A., Coo, S., Costa, R., Dikmen-Yildiz, P., Ďuríčeková, B., … the INTERSECT Consortium. (2025). Cross-national risk factors for childbirth-related PTSD: Findings from the INTERSECT study. Psychological Medicine, 55, e349. https://doi.org/10.1017/S0033291725102298
dc.identifier.doihttps://doi.org/10.1017/S0033291725102298
dc.identifier.urihttps://hdl.handle.net/11447/10918
dc.language.isoen
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subjectChildbirth
dc.subjectPTSD
dc.subjectPostpartum
dc.subjectRisk Factors
dc.titleCross-national risk factors for childbirth-related PTSD: Findings from the INTERSECT study
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourcePsychological Medicine
dspace.entity.typePublication
relation.isAuthorOfPublication08fd1772-5bed-49c3-89c7-c469e5c4f600
relation.isAuthorOfPublication7522f648-9367-4063-b91e-bb9cf539b61a
relation.isAuthorOfPublication.latestForDiscovery08fd1772-5bed-49c3-89c7-c469e5c4f600

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