Structured psychological nursing and postpartum psychological outcomes in primiparous women: a retrospective temporal cohort study.

BACKGROUND

Childbirth-related psychological symptoms may adversely affect maternal recovery and postpartum functioning. This study aimed to examine whether a structured psychological nursing program was associated with improved psychological outcomes among primiparous women.

METHODS

This single-center retrospective temporal-cohort study included 323 primiparous women with singleton deliveries in 2025. Women receiving routine nursing from January to June comprised the routine nursing group (n = 158), whereas those receiving routine care plus structured psychological nursing from July to December comprised the psychological nursing group (n = 165). Outcomes were assessed at 42 days postpartum using the City Birth Trauma Scale (City BiTS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and an institutional nursing satisfaction questionnaire. Probable childbirth-related post-traumatic stress disorder (PTSD) was determined using the complete City BiTS DSM-5 and temporal-attribution algorithm.

RESULTS

The psychological nursing group had a lower mean City BiTS score than the routine nursing group (14.1 ± 7.1 vs. 18.6 ± 8.4; mean difference, -4.50; 95% CI, -6.21 to -2.79; Hedges' g = -0.58). Probable childbirth-related PTSD occurred in 9.1% versus 17.7% of women (risk ratio, 0.51; 95% CI, 0.28-0.92). PHQ-9 and GAD-7 scores were also lower, whereas nursing satisfaction was higher. After adjustment for delivery mode and maternal age, psychological nursing remained associated with lower odds of probable PTSD (adjusted odds ratio, 0.46; 95% CI, 0.23-0.91).

CONCLUSIONS

Structured psychological nursing was associated with lower postpartum trauma, depressive, and anxiety symptom burden and greater nursing satisfaction. Prospective randomized studies are required to confirm these findings.