Prevention and treatment of PTSD following childbirth: neurobiological perspectives

AB Witteveen, Claire A. I. Stramrood, J Henrichs, Miranda Olff

Research output: Contribution to journalMeeting AbstractAcademic

Abstract

Background: Traumatic birth experiences may give rise to PTSD following childbirth (PTSD-FC). The perinatal period is associated with neurobiological alterations in HPA axis- and oxytocinergic systems also implicated in the response to trauma. However, little is known about neurobiological alterations in PTSD-FC and how these may play a role in the prevention and treatment of PTSD-FC. Recent research indicates a potential role for oxytocin.
Aim and Objectives: To provide a synthesis of evidence on epidemiology, prevention, and treatment of PTSD-FC including neurobiological alterations and treatment-potential of hormones such as oxytocin.
Method: Literature searches were performed in PubMed, Psychinfo, and Web of Science.
Results: The prevalence for PTSD-FC ranges from 3-4% in community samples to up to 19% in high risk samples. Clinical trials in the treatment or prevention of PTSD-FC are scarce and do not include neurobiological alterations but the related domains of PTSD and the perinatal period provide findings relevant for PTSD-FC. A systematic search for exogenous oxytocin trials in women with PTSD-FC generated no findings. However, direct neurobiological and psychological effects of oxytocin were positive in trials with PTSD patients albeit negative in trauma-exposed individuals. In postpartum women an oxytocin-related increase of neural processing in reward-related areas was found as well as improved therapist- and infant relationships in women with postpartum depression although their mood worsened.
Interpretation: Knowledge of epidemiological factors of PTSD-FC is adequate but research of treatment and prevention of PTSD-FC is scarce and lacks neurobiological data. Exogenous oxytocin has not been studied in PTSD-FC but treatment-relevant neurobiological and psychological changes have been found in PTSD and postpartum depression although negative oxytocin findings should also be acknowledged.
Conclusions: This review provides recommendations and cautionary notes for future research into the neurobiological aspects of preventing and treating PTSD-FC.
Original languageEnglish
Pages (from-to)e1-e43
JournalJOURNAL OF REPRODUCTIVE AND INFANT PSYCHOLOGY
Volume36
Issue number3
DOIs
Publication statusPublished - 12 Sep 2017

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