Prevalence and factors associated with posttraumatic stress disorder among post-partum mothers in Kawempe National Referral Hospital, Kampala Uganda: a cross-sectional study

Abstract

Introduction: Post-partum post-traumatic stress disorder (PTSD) can be a significant mental health concern for mothers, as many mothers may consider childbirth a traumatic event and delivery mode, lack of social support, and personal history of mental illness were sighted as some of the risk factors leading to the condition. Studies in Africa and Uganda have been focused on post-partum depression with a dearth of literature in post-partum PTSD. Kawempe Hospital registers mothers experiencing conditions like prolonged and obstructed labor, low human resource which lead to birth complications and death which predisposes mothers to post-partum PTSD after childbirth. The care tools available in the hospital lack mental health assessment components hence screening for post-partum PTSD is lacking rendering mothers with the condition unable to receive the necessary care. Objectives: This study aimed to determine the prevalence and factors associated with PTSD among post-partum mothers in Kawempe National Referral Hospital, Kampala. Methods: A cross-sectional study was conducted among randomly selected 401 post-partum mothers in Kawempe National referral hospital (KNRH). Sociodemographic data was collected using a structured questionnaire and PTSD symptoms were assessed using the DSM-5 PTSD PCL questionnaire. The data collected and analyzed using modified Poisson regression to infer association and statistical significance between independent and dependent variables. Results: The prevalence of PTSD among postnatal mothers at KNRH was 21.5% (95% CI: 18-26). The factors that were significantly associated with post-partum PTSD included; loss of a child or pregnancy (PR 0.7, CI 0.52-0.96) delivery mode; caesarian section (PR=1.50, 95% CI: 1.10-2.05), history of mental illness (PR=1.59, CI: 1.09-2.31), spousal involvement (PR=1.88, CI: 0.63-5.57), family support (PR= 2.33, CI: 1.00-5.46) and an interaction term between partner involvement and family support (PR= 0.39, CI: 0.20-0.77). Conclusion: The prevalence of post-partum PTSD among post-natal women in KNRH was at 21.5% which means 1 in 5 women will develop PTSD hence strategies to address this should be implemented to target mothers in high-risk situations like those who have lost pregnancies and babies, those with poor family relationships, and women with a history of mental illness.