Post-Traumatic Stress Disorder Severity is Associated with Pain During Pregnancy in Mothers with Substance Use Disorders

Post traumatic stress disorder (PTSD) affects approximately 8% of pregnant mothers and little is understood how PTSD, anxiety and depression affect pain during pregnancy. In mothers with substance use disorders both emotional and physical pain may be a factor in continued use during pregnancy. Continued use during pregnancy negatively affects both maternal and infant outcomes. This study's aim was to investigate the relationship between PTSD and pain outcomes (pain intensity, pain interference, and pain catastrophizing) in pregnant mothers seeking treatment for substance use disorders (SUD). Participants (N=41) were recruited during prenatal care visits for a 6-week EMA study. Enrollment criteria included trauma exposure and opiate use. The sample was reflective of the Southwest United States, 83% identified as Hispanic, 7% Native America, and 46% White. At baseline, participants ranged from 12 to 34 weeks gestation, 34% endorsed chronic pain, 75% were on MOUD, and 51% met criteria for PTSD. Mothers with a clinical diagnosis of PTSD did not have greater pain intensity, pain interference or pain catastrophizing. However, greater PTSD severity scores and number of symptoms were associated with all pain outcomes (range of r=0.31 to 0.44). Pain is prevalent in mothers with SUDs. These results suggest that a clinical diagnosis of PTSD is not as important as assessing the PTSD severity and number of symptoms when determining risk for elevated pain during pregnancy in mothers with SUD. Pain and mental health are important areas of assessment in pregnant mothers with SUD. Funding: RM1DA055301.