STRAWB2 (Stress and Wellbeing After Childbirth): a randomised controlled trial of targeted self‐help materials to prevent post‐traumatic stress disorder following childbirth

作者：Pauline Slade, Helen West, Gill Thomson, Steven Lane, Helen Spiby, RT Edwards, JM Charles, Carolina Garrett, Brendan Flanagan, Marjorie C. Treadwell, Erika Check Hayden, Andrew Weeks · 发表于：BJOG An International Journal of Obstetrics & Gynaecology · 年份：2020 · DOI：10.1111/1471-0528.16163 · 被引用次数：32 · 研究领域：Maternal Mental Health During Pregnancy and Postpartum、Maternal and Perinatal Health Interventions、Grief, Bereavement, and Mental Health

OBJECTIVES: To test whether providing psychological self-help materials would significantly lower the incidence of post-traumatic stress disorder (PTSD) at 6-12 weeks postnatally. DESIGN: Open-label randomised controlled trial, with blinded outcome assessment. SETTING: Community midwifery services in two National Health Service (NHS) trusts in the North West. SAMPLE: A cohort of 2419 women receiving normal NHS postnatal care. METHODS: Midwives screened women for traumatic birth experience; 678 women who screened positively (28.1%) were randomly allocated to self-help with usual care (n = 336) or to usual care alone (n = 342). The self-help materials were a leaflet and online film designed to prevent the development of PTSD after trauma exposure through explaining how to manage early psychological responses. MAIN OUTCOME MEASURE: The primary outcome was a composite of diagnostic and subdiagnostic PTSD at 6-12 weeks postnatally using the gold-standard Clinician-Administered PTSD Scale (CAPS-5) interview. RESULTS: Of the 678 women correctly randomised plus the nine women randomised in error, 478 (70.5%) were followed up. Diagnostic or subdiagnostic PTSD rates at follow-up did not differ between groups who received self-help (26.7%, 65/243) or usual care alone (26.2%, 64/244) (intention-to-treat analysis: RR 1.02, 95% CI 0.68-1.53). Findings remained consistent in the per-protocol analysis (RR 1.04, 95% CI 0.85-1.27). Women viewed the materials very positively. There were no adve...