OBJECTIVE: Post-traumatic stress disorder (PTSD) during pregnancy may stem from traumatic experiences during childhood or adolescence. In a sample of post-delivery Black women, we investigate the prevalence of prenatal PTSD and co-occurring depressive symptoms and examine associations with adverse childhood experiences (ACEs), sexual harassment, and unwanted sexual contact.

METHODS: Data were from the LIFE-2 cohort of Black women delivering in Detroit (2023-2025). All measures were self-report: PTSD was considered 17 on the 6-item PTSD screener from DSM-5, elevated depressive symptoms were considered 10 on the 10-item Center for Epidemiologic Studies Depression Scale, and elevated ACEs were considered 4 on the ACE-10. Experiences of sexual harassment and unwanted sexual contact was assessed for past year, ever, and age at first occurrence; childhood was defined as <18. Modified Poisson regression produced prevalence ratios (PR) and 95% CIs for prenatal PTSD adjusting for age and education.

RESULTS: Among 519 Black women, 28% experienced prenatal PTSD and 68% of those had co-occurring elevated depressive symptoms. Women with prenatal PTSD were more likely to be younger and unmarried/not living with a partner. In adjusted models, 4 ACEs (PR: 2.7; 95% CI=2.0-3.7), sexual harassment in the past year (PR=1.8, 95% CI=1.2-2.9) and ever (PR=1.7, 95% CI=1.3-2.4), and unwanted sexual contact in the past year (PR=2.8, 95% CI=1.7-4.6), ever (PR=2.3, 95% CI: 1.7-3.1), and during childhood (PR=2.2, 95% CI=1.6-3.0) were all related to an increased likelihood of prenatal PTSD.

CONCLUSION: Among this sample of Black women at delivery hospitalization, 1 in 4 experienced prenatal PTSD and of those, nearly three quarters had co-occurring depressive symptoms. ACEs and experiences of sexual harassment or unwanted sexual contact were significantly related to prenatal PTSD. Findings support the use of trauma-informed care and performing validated PTSD screening in perinatal care settings.