PhD student: Alizée Froeliger
Title: Obstetrical context and risk of post-traumatic stress disorder in post-partum
Supervisors: Catherine Deneux, Loïc Sentilhes
Doctoral school: ED 393 Epidemiology and Biomedical Information Sciences, Université Paris Cité
Among the disorders that can impair maternal mental health postpartum, posttraumatic stress disorder (PTSD) has received growing attention over the last decade. The PTSD is defined as exposure to a traumatic or stressful event and subsequent symptoms such as frequently re-experiencing it, persistently avoiding stimuli associated with it, and increased arousal symptoms. Evidence from the current literature shows that a posttraumatic stress response can develop after complex pregnancy or childbirth experiences, without any high-risk obstetric situations (e.g., extreme preterm birth or severe maternal morbidity). Apart from these, however, the prevalence and obstetric risk factors of postpartum PTSD are unclear in general populations of pregnant women. Among the presumed obstetrical risk factors, the impact of certain interventions is insufficiently documented, notably for induction of labor and mode of delivery. The continuously rising rates of induced labor and cesarean births raise questions about the psychological consequences in these sub-groups of women, whose experience of care may be specific and associated with anxiety. The identification of at-risk sub-groups and their determinants could guide targeted early detection of EPST in maternity. Finally, the trajectories of EPST between the immediate postpartum period and the weeks that follow are poorly documented.
The objectives of this thesis are to assess the prevalence and determinants of PTSD at 8 weeks after caesarean delivery, and subsequently in targeted subpopulations of at-risk women such as older primiparous women and women who have had induction of labor. Finally, we will investigate the prevalence and determinants of the various trajectories of PTSD between childbirth and 8 weeks postpartum.