Introduction: Studies from high-income countries have shown that complications in a previousrnpregnancy or at childbirth are associated with common mental disorders (CMD) and post-traumatic stressrndisorder (PTSD) in the subsequent pregnancy. Even though pregnancy and obstetric complications arernmore common in low- and middle-income countries, only a small number of studies have assessed PTSDrnsymptoms following childbirth in Africa and none have examined symptoms in the subsequentrnpregnancy.rnObjective: to test the hypothesis that previous perinatal complications are a risk factor for PTSD in thernsubsequent pregnancyrnMethods: Secondary data analysis was conducted using a dataset that is being collected as part of thernASSET (Health System Strengthening in sub-Saharan Africa) study. As part of ASSET, a cross-sectionalrnfacility-based study is being conducted among a sample of 2071 pregnant women as they present forrnantenatal care at eight selected health centers in Meskan and Sodo districts, Gurage Zone, SouthernrnNations, Nationalities and Peoplesâ€™ region. Data on socio-demographic background, depressivernsymptoms, anxiety symptoms, substance use and intimate partner violence was collected in a directrninterview using structured and standardized questionnaires. Trauma symptoms were assessed using thernLife-Event Checklist (LEC) and Post-Traumatic Stress Disorder checklist for DSM-V (PCL-5), whichrnhave been adapted for the Ethiopian setting. Data on clinical characteristics and complications of currentrnand past pregnancies was gathered from the clinical record using a structured form. For the analysis, thernprimary exposure was considered previous experience of perinatal complications and the primaryrnoutcome provisional diagnosis of PTSD using DSM-5 from PCL-5 (dependent variable).rnResult: There were 844 participants in the study and around half of the women (50.6%; n=421) were inrnthe third trimester of pregnancy. The mean age was 25.7 years (SD= 4.7) with minimum age atrnpresentation 16 years and maximum 43 years. Nearly one-third of women (31%; n=258) were pregnantrnfor the first time; the mean parity was 1.76 (SD= 1.7) with a range of 0 to 8. Slightly more than half of thernparticipant (51%) had experienced one or more potentially traumatic events. From these 47.7% of womenrnreported to have directly experienced physical assault. Women endorsed having negative feelings (such asrnfear, horror, anger, guilt or shame) more frequently than other PTSD symptoms on the PCL-5.Thernprevalence of PTSD using different criteria including the DSM-5 criteria vary between 2.9%-4.4% in thisrnstudy. There was significant association between experienced number of potentially traumatic events andrnprovisional diagnosis of PTSD using the DSM-5.rnLimitation: Multivariable analysis of the association between previous obstetric complications and PTSDrnsymptoms was not done because of the small proportion of obstetric complication. Data on otherrnsymptoms of mental health conditions including depression symptoms and care, anxiety symptoms andrnsubstance use were not included in the analysis and hence this factors was not controlled for.rnRecommendation: Slightly over half of participant women reported having been exposed to one or morerntraumatic event. Further research is needed to explore the effect of these possibly traumatic experience onrnpregnancy and outcome Symptoms like having negative feeling, irritable behavior and sleep difficultiesrnwere relatively frequent. Integrating mental health screening with ANC follow up may help improve andrnthe detection rate and care of mental health problems in pregnant women.