Abstract / Summary
Posttraumatic stress disorder (PTSD) after traumatic childbirth is a serious maternal morbidity that affects about 20% of women following medically complicated deliveries. Yet it often goes undetected in perinatal care, in part because brief screening tools suitable for busy obstetric settings are lacking. We developed and evaluated a brief screener derived from the 20-item PTSD Checklist for DSM- 5 (PCL- 5) to detect childbirth-related PTSD. Women with traumatic childbirth experiences completed the PCL- 5 and the gold-standard Clinician-Administered PTSD Scale for DSM-5 (CAPS- 5); depression symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS). Bootstrap resampling with LASSO regression identified the PCL- 5 items most strongly associated with PTSD, and Firth logistic regression was used to estimate diagnostic accuracy. A statistically derived 6-item version of the PCL- 5 (PCL- 5- R6) showed excellent discrimination against clinician diagnosis (AUC = 0.95; 95% CI, 0.89-1.00). A cut-off score of 7 yielded high sensitivity (0.96) and good specificity (0.83), with overall diagnostic efficiency of 0.86. The PCL- 5- R6 correlated only moderately with EPDS scores ({rho} = 0.53), indicating that depression screening alone does not reliably detect PTSD. This brief tool can offer a valid and practical approach for routine postpartum PTSD screening.