Associations between PTSD and pregnancy outcomes: systematic review and Meta- analysis
Bibliographic record
Abstract
IMPORTANCE: Post-Traumatic Stress Disorder (PTSD) is a prevalent and debilitating mental health condition. PTSD may be an important underlying mechanism in pregnancy and obstetric complications as well as adverse neonatal outcomes. OBJECTIVE: The primary objective of this systematic review and meta-analysis is to evaluate associations between maternal PTSD and pregnancy, obstetric and neonatal outcomes. DATA SOURCES: A comprehensive literature search was conducted using Google Scholar, PubMed, and EMBASE databases. The search included recent data from various sources: databases, indexes, registries, abstracts, proceedings, references, experts, and institutions. Terms like PTSD, perinatal, pregnancy, and neonatal outcomes were used, the search was limited to English and human studies. STUDY SELECTION: The inclusion criteria for detailed review focused on studies relevant to the topic, involving populations with perinatal PTSD, and assessing pregnancy, obstetric and neonatal outcomes. Two reviewers independently assessed the studies for eligibility, resolving discrepancies through discussion and consensus. Out of 369 initially identified studies, 40 met the selection criteria and were included in the review. DATA EXTRACTION AND SYNTHESIS: We followed PRISMA guidelines for data abstraction. Independent observers extracted data. Meta-analysis was conducted using a random-effects model, and evidence was evaluated according to GRADE guidelines. Statistical analysis was performed using R version 3.6.2. RESULTS: 40 studies were reviewed, including 27 prospective cohort, five retrospective cohort, four cross-sectional, and four case-control studies, totaling 157,708 pregnancies. Among them, 11,750 showed PTSD symptoms. Maternal PTSD was associated with smaller infant head circumference, sleeping/eating issues, reduced breastfeeding, and lower infant cortisol levels. Research varies on PTSD's connection to low birthweight (LBW) and preterm birth (PTB). Meta-analyses of available data indicated significant associations: PTSD increased LBW risk (pooled OR 2.05; 95%CI: [1.27, 3.33]) and PTB risk (pooled OR 1.23; 95%CI: [1.11, 1.37]). GRADE analysis found overall low-quality evidence for LBW and PTB. DISCUSSION & CONCLUSION: PTSD in pregnancy links to adverse outcomes in both pregnancy and neonates. Preventing PTSD and addressing its causes during this period is vital for maternal, obstetric, and neonatal health. Further research, especially on pregnancy treatment effects, is necessary for informed clinical practices and policies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.054 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.019 | 0.034 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".