CLINICAL TRIAL article
Front. Glob. Women’s Health
Sec. Women's Mental Health
This article is part of the Research TopicMaternal PTSD, Complex Trauma, Post-traumatic Growth and Resiliency across Different CulturesView all 6 articles
Glucocorticoids after Birth trauma and the Associated Risk of Developing Post-traumatic stress disorder: a Non-randomized Open-label Pilot Trial
Provisionally accepted
- Michigan Medicine, University of Michigan, Ann Arbor, United States
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Background Postpartum post-traumatic stress disorder (PTSD) occurs commonly in individuals after childbirth and is associated with adverse maternal and neonatal outcomes. The primary objective of this pilot study was to determine the acceptability and feasibility of administering glucocorticoids to reduce post-traumatic stress symptoms after a traumatic birth event. Methods This was a single-center, non-randomized, open label pilot trial conducted at Michigan Medicine. Postpartum patients who screened positive for PTSD DSM V Criterion A (felt a threat to life or injury to self or neonate) were enrolled. Participants self-selected to either (1) receive hydrocortisone within 12 hours of the traumatic event or (2) defer hydrocortisone and remain in an observational control arm. Participants were assessed at time of enrollment and multiple time points postpartum (days 3, 14, and 42) for post-traumatic stress symptoms using the City Birth Trauma Scale. The analysis compared the distribution of PTSD symptom scores in the intervention and control arm over time via weighted generalized estimating equations. Results Study recruitment was highly successful, with 133 of 138 eligible patients (96%) enrolled, and only 9 of 261 approached patients (3%) refused to be screened for study participation. Among participants who chose to receive hydrocortisone, the study drug was administered within 12 hours of birth in all cases (20/20, 100%). For the primary clinical outcome, PTSD score, 127 participants were included in the longitudinal analysis; n=19 self-selected to receive the
Keywords: Glucocorticoids, Hydrocortisone, Postpartum Hemorrhage, Mothers/psychology, Postpartum Period, Pregnancy, Stress disorders - posttraumatic, Obstetric
Received: 08 Jan 2025; Accepted: 20 Nov 2025.
Copyright: © 2025 Kountanis, Muzik, Mentz, Zhao and Vlisides. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Joanna A. Kountanis, kountani@med.umich.edu
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