Trajectories of perinatal post-traumatic stress disorder scores in association with child’s behavior at 12 months

Perinatal mental health is fundamental to a healthy society. The aim of this study was to describe the trajectories of women’s posttraumatic stress disorder (PTSD) symptoms during the perinatal period to assess their association with child behavior problems at 12 months. We designed an observational longitudinal study. Women were recruited through social media posting during the Coronavirus Disease 2019 (COVID-19) pandemic Italian national lockdown from April 8 to May 4, 2020, and contacted again at 6 and 12 months after the expected delivery date, collecting PTSD scores each time. Child behaviors were reported at 12 months postpartum. Inclusion criteria were residence in Italy, age over 18 years, and fluency in Italian. A total of 327 mother-child dyads were eligible for inclusion in the study. Clustering analysis suggested five groups of PTSD trajectories: a very low and stable (VL) group, 2 groups with decreasing PTSD symptoms over time (one high and decreasing (H-), one low and decreasing (L-)), and 2 groups with positive PTSD trajectories (one high and increasing (H+), one low and increasing (L+)). The H + and H- clusters had significantly higher risks (+ 58% and + 76% for H + and H-, respectively) for total child behavioral outcomes compared with the VL cluster, and higher risk for internalizing problems. Although many women had PTSD scores below the cut-off, we envision a significant risk for the children of mothers with elevated symptoms in pregnancy. Longitudinal modeling of perinatal PTSD symptoms is warranted for sensitive two-generation risk detection.