Cumulative effects of severe childhood maltreatment and flood-related residential displacement on PTSD risk among pregnant women in southern Brazil.

BACKGROUND

Pregnant women are at high risk of developing adverse mental health outcomes, such as posttraumatic stress disorder (PTSD), following climate-related disasters. Childhood maltreatment (CM) may be a pre-existing risk factor that increases vulnerability to PTSD in women exposed to flood-related consequences.

OBJECTIVE

To examine the associations between CM and PTSD symptoms, residential displacement due to flooding and PTSD symptoms, and to test whether these exposures interact to increase the risk for PTSD symptoms.

PARTICIPANTS AND

SETTING

This cross-sectional included 259 women who gave birth within one year after the unprecedented 2024 flood-related climate disaster in Rio Grande do Sul, southern Brazil. Participants were recruited during the puerperium from two tertiary hospitals in the state capital.

METHODS

PTSD symptoms were assessed using the PCL-5, and childhood abuse and neglect were assessed using the CTQ.

RESULTS

Both severe CM (B = 13.1, p = 0.01) and residential displacement (B = 17.0, p = 0.01) were associated with greater PTSD symptom severity. Concurrent exposure significantly amplified symptom severity, resulting in an additional increase of approximately 11.5 points in PCL-5 scores beyond the sum of their individual effects (p = 0.04). Among the CM subtypes, emotional abuse (r = 0.25, p = 0.01) was the form most significantly associated with increased vulnerability to PTSD later in life.

CONCLUSION

These findings underscore the long-term mental health consequences of cumulative traumatic exposures from childhood to adulthood in shaping the risk of PTSD, extending to the context of climate-related disasters.