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PREGNANCIES INVOLVING HYPERTENSIVE DISORDERS OF PREGNANCY ARE ASSOCIATED WITH POST-TRAUMATIC STRESS DISORDER
by
Jacqueline Hidalma Porcel
A Thesis Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
MASTER OF SCIENCE
(APPLIED BIOSTATISTICS AND EPIDEMIOLOGY)
MAY 2012
Copyright 2011 Jacqueline Hidalma Porcel
Object Description
| Title | Pregnancies involving hypertensive disorders of pregnancy are associated with post-traumatic stress disorder |
| Author | Porcel, Jacqueline Hidalma |
| Author email | jhporcel@hotmail.com;jackieporcel@gmail.com |
| Degree | Master of Science |
| Document type | Thesis |
| Degree program | Applied Biostatistics and Epidemiology |
| School | Keck School of Medicine |
| Date defended/completed | 2012-03-08 |
| Date submitted | 2012-03-11 |
| Date approved | 2012-03-12 |
| Restricted until | 2012-03-12 |
| Date published | 2012-03-12 |
| Advisor (committee chair) |
Wilson, Melissa L. Azen, Stanley P. |
| Advisor (committee member) | Ingles, Sue Ann |
| Abstract | Background: Hypertensive Disorders of Pregnancy (HDP) are complications of pregnancy that can lead to adverse perinatal and maternal outcomes. Our primary aim was to examine if HDP is associated with posttraumatic stress disorder (PTSD). Methods: We analyzed data collected through an online survey by the Preeclampsia Foundation on PTSD symptoms using the Breslau Short Screening Scale for DSM-IV. We compared participant characteristics between women with and without PTSD using chi-square tests for discrete variables and t-tests for continuous variables. Univariate and multivariate logistic regression analyses were used to examine the outcome of PTSD and identify possible risk factors associated with HDP. Results: We surveyed 1448 women (1,076 HDP, 372 controls). After adjusting for psychiatric illness or mood disorder, parity, and age at affected pregnancy, we found that women with HDP were more than four times as likely to screen positive for PTSD (OR=4.64, 95% CI: 3.37-6.39) when compared to women without HDP. Additionally, we found that PTSD symptoms increase with severity of HDP. When stratifying by severity, we found that women with gestational hypertension and preeclampsia were three and a half times more likely (OR=3.45, 95% CI: 1.70-7.00 and OR=3.48, 95% CI: 2.45-4.96, respectively); women with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome were nearly six times as likely (OR=5.76, 95% CI: 3.97-8.36), and women with eclampsia were almost ten times as likely to screen positive for PTSD (OR=9.76, 95% CI: 5.45-17.49) when compared to women without HDP. Conclusion: Pregnancies complicated by HDP are associated with increased risk of PTSD, with risk of PTSD increasing as severity of HDP increases. Medical practitioners should be aware of this association and consider screening women with HDP for signs of PTSD at their first postpartum visit. Those who screen positive could then be referred for a confirmatory diagnosis and, if needed, subsequent supportive care. |
| Keyword | hypertensive disorders of pregnancy; pregnancy; hypertension; preeclampsia; HELLP; gestational hypertension; eclampsia; PTSD; posttraumatic stress disorder. |
| Language | English |
| Part of collection | University of Southern California dissertations and theses |
| Publisher (of the original version) | University of Southern California |
| Place of publication (of the original version) | Los Angeles, California |
| Publisher (of the digital version) | University of Southern California. Libraries |
| Provenance | Electronically uploaded by the author |
| Type | texts |
| Legacy record ID | usctheses-m |
| Contributing entity | University of Southern California |
| Rights | Porcel, Jacqueline Hidalma |
| Physical access | The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright. The original signature page accompanying the original submission of the work to the USC Libraries is retained by the USC Libraries and a copy of it may be obtained by authorized requesters contacting the repository e-mail address given. |
| Repository name | University of Southern California Digital Library |
| Repository address | USC Digital Library, University of Southern California, University Park Campus MC 7002, 106 University Village, Los Angeles, California 90089-7002, USA |
| Repository email | cisadmin@dots.usc.edu |
| Archival file | uscthesesreloadpub_Volume6/etd-PorcelJacq-495.pdf |
Description
| Title | Page 1 |
| Contributing entity | University of Southern California |
| Repository email | cisadmin@dots.usc.edu |
| Full text | PREGNANCIES INVOLVING HYPERTENSIVE DISORDERS OF PREGNANCY ARE ASSOCIATED WITH POST-TRAUMATIC STRESS DISORDER by Jacqueline Hidalma Porcel A Thesis Presented to the FACULTY OF THE USC GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree MASTER OF SCIENCE (APPLIED BIOSTATISTICS AND EPIDEMIOLOGY) MAY 2012 Copyright 2011 Jacqueline Hidalma Porcel |
