Post-traumatic stress disorder in an antenatal population in South Africa: Prevalence and associated factors

Abstract

Background: The prevalence of post-traumatic stress disorder (PTSD) is uncertain globally, and there is a paucity of information in South Africa. Perinatal PTSD may impair maternal functioning and negatively affect their parenting ability.
Aim: This study aimed to determine the prevalence and associated factors of PTSD in an antenatal population in South Africa.
Setting: The study was conducted at Johan Heyns Community Health Centre in Sedibeng district, Gauteng province.
Methods: A cross-sectional questionnaire-based survey was conducted in which the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5) was administered among women attending the Johan Heyns antenatal clinic. The PCL-5 is a validated screening tool for PTSD, which comprises 20 items scored on a 5-point Likert scale for symptom severity. A total score ≥ 31 indicates at least moderate PTSD.
Results: Of the 98 pregnant women who participated in the study, 53 (54%) reported having experienced or witnessed a traumatic event. Total PCL-50 scores ranged from 0–65 (mean 13.8 standard deviation [s.d. = 18.1]), with at least one intrusion symptom endorsed by 37 women, followed by cognition and mood change by 36, arousal and reactivity by 32, and avoidance by 24. Sixteen women (16.3%) screened positive for PTSD (mean score 49.2 [s.d. = 12.7]). While univariate analysis found no significant associations with PTSD, alcohol use was associated with an increased risk of PTSD on multivariate analysis (RR 2.7; [95% confidence interval [CI] 1.1–7.0; p = 0.036).
Conclusion: Post-traumatic stress disorder is common among antenatal women in Sedibeng district and may be associated with alcohol use in pregnancy.
Contribution: This study highlights the importance of screening pregnant women for PTSD to ensure early intervention and management.