Abstract :
Keywords Post-traumatic stress disorders; Parturition; Postpartum period; Mother-child relations; Problem behavior; Object attachment Highlights * Maternal CB-PTSD(s) may be associated with less favorable mother-child attachment. * Maternal CB-PTSD(s) may be associated with more child behavior problems. * Evidence on trauma-focused therapy for CB-PTSD(s) on child outcome is of low quality. * A multidisciplinary approach to identifying young families at risk is warranted. * Confounding variables should be considered as possible explanatory factors. Abstract Introduction Maternal postnatal mental health problems may negatively impact child development. Postpartum research has mainly focused on the impact of maternal depression and anxiety due to their high prevalence (13--25 % and 10--18 %, respectively). However, maternal childbirth-related PTSD (CB-PTSD) could be another important risk factor in child development (estimated prevalence: 4.7 %). Objective We investigated whether maternal CB-PTSD (symptoms) are associated with a negative mother-child relationship and/or child developmental outcome for children aged 0--5 years. Furthermore, we examined whether maternal trauma-focused therapy can positively impact mother and child outcomes. Methods We performed a systematic review by searching three databases (Embase, Medline, PsycInfo). Search terms involved: 'birth or delivery modes', 'PTSD psychological trauma', and 'child development or child behavior'. Two independent reviewers evaluated all eligible papers. Results Thirty-five papers (30 samples) were included and qualitatively reported. Results suggest a negative association of maternal CB-PTSD (symptoms) with mother-infant attachment and child behavior. However, confounding factors may explain this association. The evidence on associations with breastfeeding, sleeping, socio-emotional development, and weight gain is insufficient. Research investigating the effect of maternal trauma-focused therapy on a child's outcome is scarce, contradictory, and of low quality. Conclusion This systematic review suggests that maternal CB-PTSD may be associated with an increased number of problems in mother-infant attachment and child behavior, but other domains remain scarcely investigated and methodologic issues are present (cross-sectional study design, influence of confounding variables, sample representativeness, diversity in assessment tools). Our results support a multidisciplinary approach to providing early prevention and screening of the maternal mental health state. Abbreviations CB-PTSD, childbirth-related posttraumatic stress disorder; CB-PTSD(s), childbirth-related posttraumatic stress disorder and/or symptoms Author Affiliation: (a) Department of Child and Adolescent Psychiatry, UPC KU Leuven, Herestraat 49, 3000 Leuven, Belgium (b) Department of Child and Adolescent Psychiatry/psychology, Erasmus MC -- Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands (c) Department of psychiatry, Erasmus MC -- Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA, the Netherlands (d) Medical Library, Erasmus MC -- Erasmus University Hospital Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands * Corresponding author. Article History: Received 9 June 2022; Revised 13 September 2022; Accepted 13 September 2022 (footnote)[white star] This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. (footnote)1 Present address: Department of Psychiatry, Hilvarenbeekseweg 605,022 GC Tilburg (The Netherlands). Byline: Sofie Van Sieleghem [vansieleghem.kinderpsychiater@gmail.com] (a,*), Marina Danckaerts (a), Rob Rieken (b), Jolanda M.E. Okkerse (b), Ellen de Jonge (c,1), Wichor M. Bramer (d), Mijke P. Lambregtse - van den Berg (b,c)