{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:32:10Z","timestamp":1793295130494,"version":"4.5.0"},"reference-count":100,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["INQUIRY"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Mothers of premature infants are at high risk of experiencing birth trauma and poor postpartum mental health. However, for some, this experience can lead to personal growth. This study examines Lithuanian women with preterm births, where birth-related PTSD is notably higher despite a lower preterm birth rate. Given the common emotional responses of guilt and shame, we explore whether proneness to these emotions moderates the relationship between birth-related PTSD and post-traumatic growth. A cross-sectional study was conducted using an anonymous e-survey to collect data. Women (N\u2009=\u200979) who experienced a preterm birth during 2020 to 2021 participated in the study at least 2\u2009months postpartum, completing the City Birth Trauma Scale (City BiTS), the Guilt and Shame Proneness Scale (GASP), and the Post Traumatic Growth Inventory (PTGI). The relationship between birth-related post-traumatic stress and post-traumatic growth was assessed using linear regression, while the roles of guilt and shame proneness in this relationship were evaluated using moderated regression. The results showed that higher birth-related post-traumatic stress symptoms were associated with greater post-traumatic growth. However, proneness to shame-related negative self-evaluation weakened this relationship, particularly in women with very preterm births. These findings suggest that trauma models should incorporate the moderating role of shame in recovery outcomes. Women with very preterm births who are prone to shame may require more focused attention from healthcare specialists, with targeted interventions to address these emotional challenges and enhance post-traumatic growth. Additionally, policy initiatives should prioritize support programs tailored to the unique psychological needs of these women.<\/jats:p>","DOI":"10.1177\/00469580241299604","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T01:49:40Z","timestamp":1733190580000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Guilt-and Shame-Proneness, Birth-related Post-traumatic Stress and Post-Traumatic Growth in Women with Preterm Birth"],"prefix":"10.1177","volume":"61","author":[{"given":"Gabija","family":"Jara\u0161i\u016bnait\u0117-Fedosejeva","sequence":"first","affiliation":[{"name":"Vytautas Magnus University, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jovita","family":"Knie\u017eait\u0117","sequence":"additional","affiliation":[{"name":"Vytautas Magnus University, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesta","family":"Sakalauskien\u0117","sequence":"additional","affiliation":[{"name":"Lithuanian University of Health Sciences, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Ayers","sequence":"additional","affiliation":[{"name":"City, University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick","family":"Bogaerts","sequence":"additional","affiliation":[{"name":"KU Leuven, Leuven, Belgium"},{"name":"University of Antwerp, Antwerp, Belgium"},{"name":"University of Plymouth, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5143-4288","authenticated-orcid":false,"given":"Olga","family":"Riklikien\u0117","sequence":"additional","affiliation":[{"name":"Lithuanian University of Health Sciences, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"key":"bibr1-00469580241299604","unstructured":"World Health Organization (WHO). Preterm birth. Published May 10, 2023. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/preterm-birth"},{"key":"bibr2-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13195"},{"key":"bibr3-00469580241299604","unstructured":"Statista. Preterm births in Europe 2015, by country. Statista; 2019. https:\/\/www.statista.com\/statistics\/953974\/preterm-births-in-europe\/"},{"key":"bibr4-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12281"},{"key":"bibr5-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000156"},{"key":"bibr6-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0191002"},{"key":"bibr7-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14368"},{"key":"bibr8-00469580241299604","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20190082"},{"key":"bibr9-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0265146"},{"key":"bibr10-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-023-01774-6"},{"key":"bibr11-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2024.102518"},{"key":"bibr12-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aaa2563"},{"key":"bibr13-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2011.07.017"},{"key":"bibr14-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1097\/NMC.0000000000000311"},{"key":"bibr15-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(12)60820-4"},{"key":"bibr16-00469580241299604","doi-asserted-by":"publisher","DOI":"10.5200\/sm-hs.2017.041"},{"key":"bibr17-00469580241299604","doi-asserted-by":"publisher","DOI":"10.3345\/cep.2023.00486"},{"key":"bibr18-00469580241299604","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2018.00359"},{"issue":"2","key":"bibr19-00469580241299604","first-page":"57","volume":"12","author":"Taylor L.","year":"2016","journal-title":"Infant"},{"key":"bibr20-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1080\/14427591.2020.1815567"},{"key":"bibr21-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.2000.00104.x"},{"key":"bibr22-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.2003.00215.x"},{"key":"bibr23-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291709992224"},{"key":"bibr24-00469580241299604","doi-asserted-by":"publisher","DOI":"10.15171\/jcs.2019.004"},{"key":"bibr25-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246758"},{"key":"bibr26-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2022.102157"},{"key":"bibr27-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.10.009"},{"key":"bibr28-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2014.05.003"},{"key":"bibr29-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1080\/08870440701864520"},{"key":"bibr30-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1207\/s15327965pli1501_01"},{"key":"bibr31-00469580241299604","doi-asserted-by":"publisher","DOI":"10.53841\/bpscpr.2013.28.4.18"},{"issue":"1","key":"bibr32-00469580241299604","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1207\/s15327965pli1501_02","volume":"15","author":"Aldwin C","year":"2004","journal-title":"Psychol Inq"},{"key":"bibr33-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-023-01360-7"},{"key":"bibr34-00469580241299604","first-page":"192","volume-title":"Handbook of Individual Differences in Social Behavior","volume":"2009","author":"Tangney J"},{"key":"bibr35-00469580241299604","doi-asserted-by":"crossref","first-page":"177","DOI":"10.7220\/2335-8769.62.11","volume":"62","author":"Germanavi\u010dius A.","year":"2014","journal-title":"Deed Dates"},{"issue":"3","key":"bibr36-00469580241299604","first-page":"419","volume":"58","author":"Lewis HB.","year":"1971","journal-title":"Psychoanal Rev"},{"key":"bibr37-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1037\/a0022641"},{"key":"bibr38-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1007\/s10826-012-9673-2"},{"key":"bibr39-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-9020.2010.00283.x"},{"key":"bibr40-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1177\/147470491000800108"},{"key":"bibr41-00469580241299604","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20042775"},{"key":"bibr42-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcbs.2023.04.004"},{"key":"bibr43-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1080\/07399330490444821"},{"key":"bibr44-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1080\/15325024.2010.519265"},{"key":"bibr45-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1348\/1476083042555442"},{"key":"bibr46-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2021.102443"},{"key":"bibr47-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22411"},{"key":"bibr48-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291722001866"},{"key":"bibr49-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1023\/A:1015255311837"},{"key":"bibr50-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1177\/1077559505276686"},{"key":"bibr51-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2017.1407202"},{"key":"bibr52-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1111\/bjc.12163"},{"key":"bibr53-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20378"},{"key":"bibr54-00469580241299604","author":"Kopecki V.","year":"2011","journal-title":"Posttraumatic Growth in Refugees: The Role of Shame and Guilt-Proneness, World Assumptions and Coping Strategies"},{"key":"bibr55-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1177\/1363461517706288"},{"key":"bibr56-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-S1-S13"},{"key":"bibr57-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1177\/01632787241239339"},{"key":"bibr58-00469580241299604","volume-title":"Using Multivariate Statistics","author":"Tabachnick B","year":"2001"},{"key":"bibr59-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1207\/s15328007sem1001_6"},{"key":"bibr60-00469580241299604","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"bibr61-00469580241299604","doi-asserted-by":"publisher","DOI":"10.47263\/jasem.4(2)01"},{"key":"bibr62-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2004.03185.x"},{"key":"bibr63-00469580241299604","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00409"},{"key":"bibr64-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1007\/BF02103658"},{"key":"bibr65-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-11-160"},{"key":"bibr66-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1097\/NMC.0000000000000259"},{"key":"bibr67-00469580241299604","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192315938"},{"key":"bibr68-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1207\/s15327965pli1501_01"},{"key":"bibr69-00469580241299604","volume-title":"Using Trauma Theory to Design Service Systems","author":"Harris M","year":"2001"},{"issue":"4","key":"bibr70-00469580241299604","first-page":"461","volume":"33","author":"Elliott DE","year":"2005","journal-title":"Am J Orthopsychiatry"},{"key":"bibr71-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogn.2020.12.005"},{"key":"bibr72-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2020.102643"},{"key":"bibr73-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201300214"},{"key":"bibr74-00469580241299604","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2018.00923"},{"key":"bibr75-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejtd.2020.100195"},{"key":"bibr76-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1080\/15298860903106843"},{"key":"bibr77-00469580241299604","doi-asserted-by":"publisher","DOI":"10.21909\/sp.2019.03.779"},{"key":"bibr78-00469580241299604","doi-asserted-by":"publisher","DOI":"10.5964\/ejop.2115"},{"key":"bibr79-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1037\/a0038235"},{"key":"bibr80-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1007\/s41811-020-00085-4"},{"issue":"1","key":"bibr81-00469580241299604","first-page":"30","volume":"15","author":"Janoff-Bulman R.","year":"2004","journal-title":"Psychol Inq"},{"key":"bibr82-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-05119-7"},{"key":"bibr83-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-078842"},{"key":"bibr84-00469580241299604","doi-asserted-by":"publisher","DOI":"10.3390\/children10091565"},{"key":"bibr85-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.507"},{"key":"bibr86-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1111\/bjc.12394"},{"key":"bibr87-00469580241299604","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S10389"},{"key":"bibr88-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.22200"},{"key":"bibr89-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1007\/s10942-006-0025-2"},{"key":"bibr90-00469580241299604","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2018.02131"},{"key":"bibr91-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1207\/s15327965pli1502_01"},{"key":"bibr92-00469580241299604","volume-title":"Stress, Coping, and Development, Second Edition: An Integrative Perspective","author":"Aldwin C.","year":"2009"},{"key":"bibr93-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1002\/aps.1793"},{"key":"bibr94-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-10-S1-S2"},{"key":"bibr95-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715002706"},{"key":"bibr96-00469580241299604","doi-asserted-by":"publisher","DOI":"10.4324\/9781410603401"},{"key":"bibr97-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.nwh.2021.03.003"},{"key":"bibr98-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2021.12.003"},{"key":"bibr99-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1002\/rfc2.33"},{"key":"bibr100-00469580241299604","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.06.076"}],"container-title":["INQUIRY: The Journal of Health Care Organization, Provision, and Financing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00469580241299604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00469580241299604","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00469580241299604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:09:55Z","timestamp":1777460995000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00469580241299604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":100,"alternative-id":["10.1177\/00469580241299604"],"URL":"https:\/\/doi.org\/10.1177\/00469580241299604","relation":{},"ISSN":["0046-9580","1945-7243"],"issn-type":[{"value":"0046-9580","type":"print"},{"value":"1945-7243","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"article-number":"00469580241299604"}}