***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The purpose of this study was to determine the association between posttraumatic stress disorder ( PTSD ) , diagnosed prospect ively during pregnancy , and the risk of delivering a low birth weight ( < 2500 g ) or preterm ( < 37 weeks gestational age ) infant . METHODS Pregnant women were recruited from obstetrics clinics and screened for major and minor depressive disorder , panic disorder , PTSD , and substance use . Current episodes of PTSD were diagnosed according to the MINI International Neuropsychiatric Interview , and pregnancy outcomes were abstract ed from hospital records . RESULTS Among the 1100 women included in analysis , 31 ( 3 % ) were in episode for PTSD during pregnancy . Substance use in pregnancy , panic disorder , major and minor depressive disorder , and prior preterm delivery were significantly associated with a diagnosis of PTSD . Preterm delivery was non-significantly higher in pregnant women with ( 16.1 % ) compared to those without ( 7.0 % ) PTSD ( OR=2.82 , 95 % C.I. 0.95 , 8.38 ) . Low birth weight ( LBW ) was present in 6.5 % of women and was not significantly associated with a diagnosis of PTSD in pregnancy after adjusting for potential confounders . However , LBW was significantly associated with minor depressive disorder ( OR=1.82 , 95 % C.I. 1.01 , 3.29 ) . LIMITATIONS There was a low prevalence of PTSD in this cohort , result ing in limited power . CONCLUSIONS These data suggest a possible association between PTSD and preterm delivery . Coupled with the association found between LBW and a depressive disorder , these results support the utility of screening for mental health disorders in pregnancy BACKGROUND Childbirth has been linked to postpartum impairment . However , controversy exists regarding the onset and prevalence of post-traumatic stress disorder ( PTSD ) after childbirth , with seminal studies being limited by method ological issues . This longitudinal prospect i ve study examined the prevalence of PTSD following childbirth in a large sample while controlling for pre-existing PTSD and affective symptomatology . METHOD Pregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy , 4 - 6 weeks postpartum , 12 weeks postpartum and 24 weeks postpartum . RESULTS Of the 1067 women approached , 933 were recruited into the study . In total , 866 ( 93 % ) were retained to 4 - 6 weeks , 826 ( 89 % ) were retained to 12 weeks and 776 ( 83 % ) were retained to 24 weeks . Results indicated that , uncontrolled , 3.6 % of women met PTSD criteria at 4 - 6 weeks postpartum , 6.3 % at 12 weeks postpartum and 5.8 % at 24 weeks postpartum . When controlling for PTSD and partial PTSD due to previous traumatic events as well as clinical ly significant anxiety and depression during pregnancy , PTSD rates were less at 1.2 % at 4 - 6 weeks , 3.1 % at 12 weeks and 3.1 % at 24 weeks postpartum . CONCLUSIONS This is the first study to demonstrate the occurrence of full criteria PTSD result ing from childbirth after controlling for pre-existing PTSD and partial PTSD and clinical ly significant depression and anxiety in pregnancy . The findings indicate that PTSD can result from a traumatic birth experience , though this is not the normative response BACKGROUND AND OBJECTIVES Pregnant women face considerable barriers to smoking cessation . The purpose of this study was to determine the prevalence of major depressive disorder ( MDD ) and post-traumatic stress disorder ( PTSD ) and response to  smoking cessation treatment  in pregnant smokers participating in a r and omized , placebo-controlled trial of nicotine gum .  METHODS Participants were 194 low-income , ethnically diverse pregnant smokers . RESULTS Utilizing a structured interview , 45 % and 18 % of the subjects met criteria for a lifetime diagnosis of MDD and PTSD , respectively . There was no difference in response to treatment , based on the presence of either of these psychiatric disorders . CONCLUSIONS Cumulatively , these findings provide evidence of the high degree of unmet mental health needs in pregnant smokers . SCIENTIFIC SIGNIFICANCE Pregnant women with a history of MDD and PTSD appear to be as likely to benefit from  smoking cessation treatment as those without such a history OBJECTIVE To test the effectiveness of a trauma-specific , psychoeducational intervention for pregnant women with a history of childhood maltreatment on six intrapartum and postpartum psychological outcomes . DESIGN Quasi-experimental study comparing women from a single-group , pretest-posttest pilot intervention study with women matched from a prospect i ve observational study . SETTING Rural and university-based prenatal clinics . PARTICIPANTS Pregnant women entered the study by responding to an advertisement or by referral from a maternity care provider . Women could take part whether or not they met posttraumatic stress disorder diagnostic criteria . Outcomes data exist for 17 pilot intervention study participants and 43 matched observational study participants . INTERVENTIONS Participants in the observational study received usual care . Participants in the pilot intervention study received usual care plus the intervention , a fully manualized , self- study program supported by weekly phone tutoring sessions with a health professional . MAIN OUTCOME MEASURES The National Women 's Study PTSD Module , the Peritraumatic Dissociation Experience Question naire , the Perception of Care Question naire , the Postpartum Depression Screening Scale , the Postpartum Bonding Question naire , and a semantic differential appraisal of the labor experience . RESULTS Participants in the intervention study had better scores on all measures . Differences in means between participants in the intervention study and participants in the observational study equated to medium effect sized for dissociation during labor , rating of labor experience , and perception of care in labor and small effect sizes for postpartum posttraumatic stress disorder ( PTSD ) symptoms , postpartum depression symptoms , and motherinfant bonding . CONCLUSION This trauma-specific intervention reaches and benefits pregnant women with a history of childhood maltreatment OBJECTIVE The purpose of this study was to examine symptoms of posttraumatic stress disorder ( PTSD ) in a community sample of low-income pregnant women who met the DSM-IV diagnostic criteria for the disorder . METHOD Pregnant women ( N=948 ) were screened for trauma , PTSD , depression , and co-occurring illicit substance use .  PTSD symptoms were compared in traumatized pregnant women and a sample of nonpregnant traumatized women from the National Comorbidity Survey . RESULTS Suicidal thoughts and a high degree of psychiatric comorbidity were common in pregnant women with PTSD . Pregnant women were selectively and significantly less likely to endorse reexperiencing symptoms of PTSD ( 29.5 % , N=82 ) , compared to nonpregnant women ( 79.4 % , N=464 ) . CONCLUSIONS PTSD in pregnancy was associated with comorbidity , poor health behaviors , and lower recall of memory-related PTSD symptoms . Further prospect i ve study is needed IMPORTANCE Posttraumatic stress disorder ( PTSD ) occurs in about 8 % of pregnant women . Stressful conditions , including PTSD , are inconsistently linked to preterm birth .  Psychotropic treatment has been frequently associated with preterm birth . Identifying whether the psychiatric illness or its treatment is independently associated with preterm birth may help clinicians and patients when making management decisions . OBJECTIVE To determine whether a likely diagnosis of PTSD or antidepressant and benzodiazepine treatment during pregnancy is associated with risk of preterm birth . We hypothesized that pregnant women who likely had PTSD and women receiving antidepressant or anxiolytic treatment  would be more likely to experience preterm birth . DESIGN , SETTING , AND PARTICIPANTS Longitudinal , prospect i ve cohort study of 2654 women who were recruited before 17 completed weeks of pregnancy from 137 obstetrical practice s in Connecticut and Western Massachusetts . EXPOSURES Posttraumatic stress disorder , major depressive episode , and use of antidepressant and benzodiazepine medications . MAIN OUTCOMES AND MEASURES Preterm birth , operationalized as delivery prior to 37 completed weeks of pregnancy . Likely psychiatric diagnoses were generated through administration of the Composite International Diagnostic Interview and the Modified PTSD Symptom Scale . Data on medication use were gathered at each participant interview . RESULTS Recursive partitioning analysis showed elevated rates of preterm birth among women with PTSD . A further split of the PTSD node showed high rates for women who met criteria for a major depressive episode , which suggests an interaction between these 2 exposures . Logistic regression analysis confirmed risk for women who likely had both conditions ( odds ratio [ OR ] , 4.08 [ 95 % CI , 1.27 - 13.15 ] ) . For each point increase on the Modified PTSD Symptom Scale ( range , 0 - 110 ) , the risk of preterm birth increased by 1 % to 2 % . The odds of preterm birth are high for women who used a serotonin reuptake inhibitor ( OR , 1.55 [ 95 % CI , 1.02 - 2.36 ] ) and women who used a benzodiazepine medication ( OR , 1.99 [ 95 % CI , 0.98 - 4.03 ] ) . CONCLUSIONS AND RELEVANCE Women with likely diagnoses of both PTSD and a major depressive episode are at a 4-fold increased risk of preterm birth ; this risk is greater than , and independent of , antidepressant and benzodiazepine use and is not simply a function of mood or anxiety symptoms Background : Many women experience childbirth as traumatic and 2 % develop post-traumatic stress disorder . This study examined the role of health practitioner support and personal control during birth as predictors of post-traumatic stress ( PTS ) symptoms , adjusting for vulnerability factors of prior trauma , depression , control beliefs and birth intervention . It also investigated interactions between support , prior trauma and birth intervention and their association with PTS symptoms . Methods : A prospect i ve longitudinal survey of 138 women recruited from UK NHS maternity clinics . Measures were taken in pregnancy , 3 weeks and 3 months after the birth . Results : Support and control during birth were not predictive of postnatal PTS symptoms . However , support was predictive of PTS symptoms in a subset of women with prior trauma ( β = −0.41 , R 2 = 16 % ) at both 3-weeks and 3-months postpartum . The interaction of birth intervention and support was associated with PTS symptoms 3 months after birth , the relationship between support and PTS symptoms was stronger in women experiencing more intervention . Conclusions : Low support from health practitioners is predictive of postnatal PTS symptoms in women who have a history of trauma . Longer term effects of low support on postnatal PTS symptoms are also found in women who had more intervention during birth Background Prenatal assessment for psychosocial risk factors and prevention and intervention is scarce and , in most cases , nonexistent in obstetrical care . In this study we aim ed to evaluate if the KINDEX , a short instrument developed in Germany , is a useful tool in the h and s of non-trained medical staff , in order to identify and refer women in psychosocial risk to the adequate mental health and social services . We also examined the criterion-related concurrent validity of the tool through a validation interview carried out by an expert clinical psychologist . Our final objective was to achieve the cultural adaptation of the KINDEX Greek Version and to offer a valid tool for the psychosocial risk assessment to the obstetric care providers . Methods Two obstetricians and five midwives carried out 93 KINDEX interviews  ( duration 20 minutes ) with pregnant women to assess psychosocial risk factors present during pregnancy . Afterwards they referred women who they identified having two or more psychosocial risk factors to the mental health attention unit of the hospital . During the validation procedure an expert clinical psychologist carried out diagnostic interviews with a r and omized sub sample of 50 pregnant women based on established diagnostic instruments for stress and psychopathology , like the PSS-14 , ESI , PDS , HSCL-25 . Results Significant correlations between the results obtained through the assessment using the KINDEX and the risk areas of stress , psychopathology and trauma load assessed in the validation interview demonstrate the criterion-related concurrent validity of the KINDEX . The referral accuracy of the medical staff is confirmed through comparisons between pregnant women who have and have not been referred to the mental health attention unit . Conclusions Prenatal screenings for psychosocial risks like the KINDEX are feasible in public health setting s in Greece . In addition , validity was confirmed in high correlations between the KINDEX results and the results of the validation interviews . The KINDEX Greek version can be considered a valid tool , which can be used by non-trained medical staff providing obstetrical care to identify high-risk women and refer them to adequate mental health and social services . These kind of assessment s are indispensable for the promotion of a healthy family environment and child development Background High levels of stress due to diverse psychosocial factors have a direct impact on the mothers ’ wellbeing during pregnancy and both direct and indirect effects on 
    Output:
    
PTSD is prevalent during pregnancy and after birth and may increase postpartum if not identified and treated .