Early psychological interventions for prevention and treatment of post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms in post-partum women: a systematic review and meta-analysis protocol

P. G. Taylor Miller, Marlene Sinclair, Patricia Gillen, Paula Miller, Julie Mc Cullough, Derek Farrell, Paul F Slater, Elan Shapiro, Phyllis Klaus

Research output: Contribution to journalLiterature reviewpeer-review

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Abstract

Background: One in 10 women experience post-traumatic stress disorder (PTSD) at four
to six weeks following birth, with rates of 15.7 per cent in high-risk populations. PTSD is
highly comorbid with other mental health conditions, and an expanding evidence base
has identified that symptoms of PTSD and accompanying comorbidities have a detrimental
effect on women, infants and the family system.
Objectives: This protocol will guide a systematic literature review and meta-analysis
that aims to estimate the effect of early interventions on PTSD and post-traumatic
stress symptoms in women following a traumatic birth. The protocol follows the PICOS
framework.
Methods: There will be no limitation on the geographical location in which the studies
are conducted. The population of interest are pregnant and postpartum women who have
experienced a traumatic birth. Experimental interventions include any early psychological
intervention delivered within three months of a traumatic birth experience as secondary
prevention, or before birth as primary prevention. Usual care or any active intervention will
be included as comparator interventions. The primary outcome is post-traumatic stress
disorder or post-traumatic stress symptoms. Randomised controlled trials (RCTs) or pilot
studies will be included in the review.
Results: Eleven electronic databases will be searched, data will be extracted, and metaanalysis will be conducted in Review Manager 5. Heterogeneity between studies will be
measured by the I² test and Chi-squared test. Risk of bias assessments will be conducted in
accordance with the criteria outlined in the Cochrane Handbook for Systematic Reviews of
interventions. Strength of evidence will be evaluated by the Grading of Recommendations,
Assessment, Development and Evaluations (GRADE) approach. Five reviewers will discuss
study selection, data extraction and quality assessment. Results will be synthesised to
formative narrative summary if there is insufficient data to conduct meta-analysis.
Conclusions: This protocol explains the methodology of a systematic literature review and
meta-analysis of early psychological interventions in preventing PTSD and traumatic stress
symptoms in women following a traumatic birth. Protocol development has been informed
by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols
guidance (PRISMA-P).
Original languageEnglish
Pages (from-to)12-18
Number of pages7
JournalEvidence Based Midwifery
Volume20
Issue number2
Publication statusPublished - 16 Dec 2021

Keywords

  • perinatal trauma
  • early intervention
  • psychological intervention
  • post-traumatic stress disorder
  • PTSD
  • birth
  • trauma
  • midwifery
  • review
  • protocol
  • Evidence Based Midwifery

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