Predictors of positive prenatal PTSD screens in low-income Native Hawaiian women

Perinatal PTSD been researched in any depth only recently; however, the causes and consequences of this serious illness remain unclear. Most commonly, childbirth trauma and interpersonal violence have been reported as contributing factors. Native Hawaiian and Pacific Islander (NHPI) women are reported to have a greater risk for PTSD than other ethnic groups in Hawaii, in part due to their higher rates of interpersonal violence. It is not clear which personal, social and health related variables are predictive of PTSD in this population. The purpose of this case-control study was to determine the predictors associated with perinatal PTSD among NHPI. Medical record data (demographics, social circumstances and health-related variables previously associated with perinatal PTSD) were collected on prenatal NHPI women who screened positive (n=55) and who screened negative (n=91) for PTSD at a community health center. Within the sample, 97 (66.4%) women had experienced interpersonal violence. Hierarchical logistic regression was conducted to determine PTSD risk factors and to assess the effect size of predictors. Significant predictors were family support (OR=5.64, p =0.000), violence with the use of a weapon (OR=4.27, p =0.37), history of depression (OR=2.84, p =0.019), family stress (OR=2.47, p =0.038). Although the majority of women experienced some form of interpersonal violence, only the most extreme form of violence was a predictor of PTSD; highlighting the level of violence normalized in this low-income community. Family support and discord are key areas for providers' assessments and may be amenable to change with targeted interventions, unlike many other social circumstances.