A systematic review on the assessment of pregnancy-specific psychological trauma during pregnancy: A call to action

Abstract

Objective: Psychological trauma negatively impacts maternal and infant health during the perinatal period. A history of traumatic experiences related to previous pregnancies and births (termed pregnancy-specific psychological trauma or PSPT) increases the risk of a host of psychological disorders. It can impede women's/the pregnant individual's relationship with the healthcare system and their developing child. There are, however, no guidelines or agreed-upon validated screening measures to assess PSPT during the perinatal period. To build a knowledge base to develop future measure(s) of PSPT, we conducted a systematic review to understand how and when PSPT has been measured during pregnancy. Data sources: Searches were run in July 2021 on the following databases: Ovid MEDLINE (In-Process & Other Non-Indexed Citations and Ovid MEDLINE 1946 to Present), Ovid EMBASE (1974 to present), Scopus, Web of Science, PsycInfo, and Cochrane. Updated searches and reference searching/snow-balling were conducted in September 2023. Study eligibility criteria: The search strategy included all appropriate controlled vocabulary and keywords for psychological trauma and pregnancy. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Two independent researchers screened abstracts and, subsequently, full-texts of abstracts for appropriateness, with conflicts resolved via a third independent reviewer. A secondary analysis was performed on studies measuring PSPT during pregnancy. Results: Of the 576 studies examining psychological trauma in pregnancy, only 15.8% (n=91) had a measure of PSPT. Of these 91 studies, 53 used a measure designed by the research team to assess PSPT. Critically, none of the measurements used screened for PSPT comprehensively. Conclusion: It is time to screen for and study PSPT in all perinatal individuals. Recognition of PSPT should promote trauma-informed care delivery by obstetrics and neonatology/pediatric teams during the perinatal period.