Perinatal PTSD trajectories in Pandemic exposed Pregnancies: Parenting and Child Development outcomes

Maternal mental health is a vulnerable aspect during the perinatal period, which is also susceptible to adverse environmental conditions (i.e., natural disasters, pandemics…). However, compared to mood and anxiety disorders, little is currently known about perinatal PTSD, its trajectories over time and its associated risk factors and implications. Here, we investigated PTSD psychopathology longitudinally in a cohort of pregnant women during the first Italian lockdown due to the Covid-19 pandemic. More precisely, we explored their PTSD symptoms from pregnancy up to twelve months postpartum, considering various possible predictors (i.e., socio-demographic, environmental and clinical-obstetric features) and future parenting (i.e., parenting stress and parental burnout) and child development (infant emotional and behavioral regulation) outcomes. The abovementioned elements were collected through self-report measures in 327 mothers who completed the three assessments administered both prenatally and postnatally (i.e., at six and twelve months from childbirth). These women, depending on their symptoms’ persistence and onset timing, were divided in different subgroups, obtaining thus several PTSD trajectories (i.e., resilient-, recovered-, delayed- and chronic-PTSD). Results showed a general increase in perinatal PTSD levels of our sample compared to available data in literature, and resilient trajectories in most of mothers, confirming the negative effect of the pandemic on maternal mental health, but also the fact that the health trajectory is the normative one. Also, a negative effect on PTSD onset of previous potentially traumatic events and of unplanned pregnancy was registered, showing the importance of considering these aspects in screening processes. Lastly, we can observe a deleterious influence of PTSD on parenting, while, in contrast with previous evidence, no association was found between perinatal PTSD and temperamental and behavioral problems of children. These results highlight a potential higher vulnerability of psychological well-being of pregnant women in terms of PTSD during the pandemic. And this conclusion comes with the implication of the need of better investigating this specific psychopathology over time, considering associated predictors and future consequences, on which work to raise awareness of clinicians is necessary, trying to preserve maternal and child welfare.