City Research Online

Validation of the City Birth Trauma Scale in Italian: addressing childbirth-related posttraumatic stress disorder

Ciuffo, G., Ionio, C., Epifania, O. M. , Landoni, M., Bianchi, S., Webb, R. ORCID: 0000-0002-8862-6491, Constantinou, G. ORCID: 0000-0002-2389-7901 & Ayers, S. ORCID: 0000-0002-6153-2460 (2025). Validation of the City Birth Trauma Scale in Italian: addressing childbirth-related posttraumatic stress disorder. Journal of Reproductive and Infant Psychology, doi: 10.1080/02646838.2025.2546969

Abstract

Background and aim: It is estimated that 19% of women experience childbirth as traumatic, and around 4% develop post-traumatic stress disorder (PTSD) as a result. The City Birth Trauma Scale was developed specifically to assess childbirth-related trauma according to recognised diagnostic criteria. This study aimed to translate and validate the City Birth Trauma Scale in Italian (City BiTS-IT) and investigate its psychometric properties to enhance early detection and intervention.

Methods: The sample consisted of 255 postpartum women aged 18–38 years. Participants completed the INTERSECT Survey which includes the City Birth Trauma Scale (City BiTS). The bi-factor model was applied to assess the latent structure of the scale, and convergent and divergent validity were evaluated.

Results: The City BiTS-IT demonstrated good fit to the data, with high internal consistency (ω = 0.93) and reliability (ECV = 51%). Subscales of Birth-related symptoms and General symptoms showed good reliability (ω = 0.90, ω = 0.89, respectively). Convergent validity analyses revealed strong correlations between City BiTS-IT and depression (EPDS; r = 0.59). Birth-related symptoms correlated more strongly with birth satisfaction scores (BSS-R; r = -0.68), highlighting the impact of traumatic birth experiences on maternal satisfaction. The prevalence of childbirth-related PTSD was 2.4%.

Conclusion: The validation of the City BiTS-IT provides a valuable tool for healthcare professionals in Italy to identify and intervene early in cases of CB-PTSD. Future research should focus on longitudinal studies to understand the progression of CB-PTSD symptoms and develop tailored interventions for at-risk populations.

Publication Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Reproductive and Infant Psychology on 13 Aug 2025, available at: https://doi.org/10.1080/02646838.2025.2546969
Publisher Keywords: Childbirth-related posttraumatic stress disorder, city birth trauma scale, validation study, psychometric properties, postpartum mental health
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RG Gynecology and obstetrics
Departments: School of Health & Medical Sciences
School of Health & Medical Sciences > Department of Nursing & Midwifery
SWORD Depositor:
[thumbnail of Ciuffo et al 2025_text copy.pdf] Text - Accepted Version
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