Post-traumatic Stress Disorder in Women undergoing Caesarean Section: A prospective hospital-based study from Sindh, Pakistan.

OBJECTIVES

To study the prevalence of post-traumatic stress disorder (PTSD) in hospital-based population of women undergoing C-section and determine its association with demographic and clinical factors.

METHODS

It was a prospective study and conducted between 2022 to 2024 at the Department of Obstetrics and Gynecology, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan. A total of 265 women undergoing C-sections were recruited from multiple hospitals in Sindh, Pakistan, including LUMHS Hyderabad and Jamshoro, Bilawal Medical College, LUMHS, Sindh Government Hospital Qasimabad, and Hashim Medical City Hospital, Hyderabad. PTSD symptoms were assessed using the PTSD Checklist for DSM-5 (PCL-5) at week-1 and followed up at 6 weeks post C-section. The Life Events Checklist 5 (LEC-5) was used to document traumatic experiences. Data was analyzed using the paired samples t-test to compare PTSD scores within groups between week 1 and week 6, and the independent t-test to compare PTSD scores between elective and emergency C-sections. Multivariate logistic regression was performed to identify significant predictors of PTSD while adjusting for confounders. Statistical significance was set at p < 0.05.

RESULTS

The mean age of participants was 29.9 ± 5.3 years, and the mean gestational age was 37.4 ± 1.5 weeks. PTSD scores at one-week post-C-section showed a mean score of 6.72 ± 4.35 for all C-sections, with elective C-sections having a mean score of 6.27 ± 4.35 and emergency C-sections having a mean score of 7.23 ± 4.31 (P-value: 0.077). At six weeks post-C-section, the mean PTSD score was 7.95 ± 6.30 for all C-sections, with elective C-sections having a mean score of 7.34 ± 6.05 and emergency C-sections having a mean score of 8.64 ± 6.53 (P-value: 0.095). A significant increase in PTSD scores from one to six weeks was observed in both groups (p < 0.001). Multivariate logistic regression identified prolonged hospital stay (>5 days) as a significant predictor of PTSD (adjusted odds ratio [AOR] = 42.50, p = 0.013).

CONCLUSION

PTSD prevalence increased from the immediate postoperative period to six weeks post C-section, highlighting the need for early psychological assessment and intervention in postpartum women, particularly those with prolonged hospital stays following C-sections.