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Poster Session 3

Category: Perinatal Mental Health

Poster Session 3

(713) Trajectories of posttraumatic stress symptoms after a vaginal delivery: a multicenter prospective study

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Alizee Froeliger, MD, MPH (she/her/hers)

Attending Physician
Department of Obstetrics and Gynecology, Bordeaux University Hospital
Department of Obstetrics and Gynecology, Bordeaux University Hospital, France., Aquitaine, France

Coauthor(s)

CD

Catherine Deneux-Tharaux, MD, PhD

Université Paris Cité Institut Santé Des Femmes, Centre for Research in Epidemiology and Statistics (CRESS) U1153, Obstetrical Perinatal and Pediatric Epidemiology Research Team (Epopé), INSERM, INRAE, Paris, France.
Paris, Ile-de-France, France
Lola Loussert, MD, MPH (she/her/hers)

OPPaLE team, Centre for Research in Epidemiology and Statistics (CRESS) U1153, INSERM
Department of Obstetrics and Gynecology, Toulouse University Hospital, France., Languedoc-Roussillon, France
AS

Anne Laure Sutter-Dallay, MD, PhD

Department of Perinatal Psychiatry, Charles Perrens Hospital, Bordeaux University Hospital
Department of Perinatal Psychiatry, Charles Perrens Hospital, Bordeaux University Hospital, France, Aquitaine, France
Hugo Madar, MD, PhD (he/him/his)

Doctor of Medicine in Obstetrics and Gynecology – Maternal Fetal Medicine
Bordeaux University Hospital
Bordeaux Universitary Hospital, Aquitaine, France
Loïc Sentilhes, FRCOG, MD, PhD (he/him/his)

Professor in Obstetrics and Gynecology – Maternal Fetal Medicine
Bordeaux University Hospital
Bordeaux Universitary Hospital, Aquitaine, France

Objective:
To characterize trajectories of posttraumatic stress symptoms between 2 days and 2 months after vaginal delivery at or near term and identify associated risk factors.

Study Design:
Ancillary cohort study of the TRAAP randomized controlled trial in 15 French university hospitals (2015–2016), including women who delivered vaginally after 35 weeks. Endpoint was

posttraumatic stress symptoms

assessed at day 2 and 2 months postpartum using the validated Impact of Event Scale-Revised (IES-R). Four trajectories were defined: asymptomatic (IES-R score< 22 at both), recovered (≥22 at day 2, < 22 at 2 months), emerging (< 22 at day 2, ≥22 at 2 months), and persistent (≥22 at both). Prevalences were corrected using inverse probability weighting to account for nonresponse. Associations with risk factors were examined using multivariate logistic regression.

Results:
At both timepoints 2344/3891 women completed the IES-R (60.2% response). Corrected prevalences were: asymptomatic 83.4% (95%CI, 81.8–85.0), recovered 11.0% (95%CI, 9.7–12.4), emerging 2.1% (95%CI, 1.6–2.8), and persistent 3.5% (95%CI, 2.7–4.4). In women without acute stress symptoms at day 2, emerging symptoms were associated with previous abortion (aOR 2.6; 95%CI, 1.6–3.9), pregnancy hospitalization (aOR 2.8; 95%CI, 1.4–4.7), labor induction (aOR 1.7; 95%CI, 1.1–2.8), bad delivery memories at day 2 (aOR 3.7; 95%CI, 1.4–5.6), intense fatigue at day 2 (aOR 2.2; 95%CI, 1.4–3.5), and was reduced by epidural (aOR 0.2; 95%CI, 0.1–0.7). In women with acute stress symptoms at day 2, persistent symptoms were associated with younger age (aOR 0.8; 95%CI, 0.6–0.9 per +5 years), non-European origin (aOR 1.8; 95%CI, 1.2–2.6), psychiatric history (aOR 1.9; 95%CI, 1.2–2.4), bad delivery memories (aOR 2.4; 95%CI, 1.3–4.6), and hemoglobin < 9g/dL at day 2 (aOR 1.8; 95%CI, 1.1–2.7).

Conclusion:
After term vaginal delivery, 5.6% of women had persistent or emerging posttraumatic stress trajectories up to 2 months postpartum. Persistent trajectories were mainly linked to preexisting factors, while emerging trajectories were more closely tied to obstetrical events.