Increased traumatic childbirth and postpartum depression and lack of exclusive breastfeeding in Black and Latinx individuals.
Increased traumatic childbirth and postpartum depression and lack of exclusive breastfeeding in Black and Latinx individuals.
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DOI：
10.1002/ijgo.14280
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发表时间：
2022-09
影响因子：
3.8
通讯作者：
Dekel, Sharon
中科院分区：
文献类型：
--
作者：
Iyengar, Ananya S.;Ein-Dor, Tsachi;Zhang, Emily X.;Chan, Sabrina J.;Kaimal, Anjali J.;Dekel, Sharon
关键词：
2 |。材料与方法本匿名研究调查于2020年4月2日启动。在这里，我们报告了236名少数民族妇女（黑人/非裔美国人或西班牙裔/拉丁裔）和236名非西班牙裔白人妇女，她们都在大流行期间分娩，COVID-19感染呈阴性。我们收集了他们的分娩、母婴行为、创伤（虐待）史和心理健康的信息。根据人口统计学因素（即产妇年龄、婚姻、就业、教育、收入状况和居住国家）、产后月份和调查完成日期进行匹配。麻省总院布里格姆人类研究委员会授予该研究豁免权。估计算法采用logistic回归，匹配算法采用最近邻匹配，推荐卡尺为0.2。5采用创伤期应激量表（PDI）评估分娩急性创伤应激6采用爱丁堡产后抑郁量表（EPDS）测量产后抑郁症状。73 |。结果产妇平均产后2个月（53.2%为初产妇，平均年龄31岁，95.6%≥37孕周，68.2%为阴道分娩）。测量独立性的卡方检验（表1）显示，与非西班牙裔白人妇女相比，少数族裔报告临床相关的急性分娩创伤应激的可能性高出三倍，报告产后抑郁的可能性高出两倍。对于暴露于创伤的个体，这种程度的应激症状表明有患创伤后应激障碍的风险。8 Logistic回归显示，在控制了精神健康和虐待史、既往妊娠并发症（如流产、死胎、早产）和与近期分娩相关的并发症（如计划外剖宫产、产科并发症和新生儿重症监护病房入院）后，这些组间差异仍然存在，OR, 2.9；急性应激的95% CI为1.69-5.10 [P< 0.001]， OR为1.97；产后抑郁的95% CI为1.29-3.04 [P< 0.01]。少数民族也有更多的意外剖宫产和更少的直接母婴亲密行为的发生率。其他与出生有关的因素没有差异。
2|. MATERIALS AND METHODSThis anonymous study survey was launched on April 2, 2020. 1, 4 Here we report on 236 minority women (Black/African-American or Hispanic/Latinx) and 236 non-Hispanic White women, all of whom gave birth during the pandemic and were negative for COVID-19 infection. We collected information about their childbirth, maternal-infant behaviors, and trauma (abuse) history and mental health. The groups were matched on demographic factors (ie, maternal age, marital, employment, education, and income status, and country of residence), month postpartum, and survey completion date. The Mass General Brigham Human Research Committee granted the study exempt. The estimation algorithm was logistic regression, and the matching algorithm was nearest neighbor matching with caliper of 0.2 as recommended. 5 The Peritraumatic Distress Inventory (PDI) was used to assess acute traumatic stress to childbirth 6 and the Edinburgh Postnatal Depression Scale (EPDS) was used to measure postpartum depression symptoms. 73|. RESULTSParticipants were on average 2 months postpartum (53.2% primiparas; average maternal age, 31 years; 95.6%≥ 37 gestational week; 68.2% vaginal delivery). Chi-square tests for independence of measures (Table 1) showed that the minority group were three times more likely to report clinically-relevant acute traumatic stress to childbirth and two times more likely to report postpartum depression than non-Hispanic White women. For trauma-exposed individuals, stress symptoms at this level are indicative of risk for post-traumatic stress disorder. 8 Logistic regressions revealed that these group differences remained after controlling for mental health and abuse history, prior pregnancy complications (ie, miscarriage, stillbirth, premature birth), and complications associated with recent delivery (eg, unplanned cesarean, obstetrical complications, and neonatal intense care unit admission), OR, 2.9; 95% CI, 1.69–5.10 [P< 0.001] for acute stress, and OR, 1.97; 95% CI, 1.29–3.04 [P< 0.01] for postpartum depression. Minorities also had more incidences of unplanned cesarean and fewer incidences of immediate mother-infant bonding behaviors. Other birth-related factors did not differ.
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影响因子：
10.6
作者：
van Zuiden, Mirjam;Frijling, Jessie L.;Olff, Miranda
通讯作者：
Olff, Miranda
DOI：
10.1016/s2214-109x(21)00079-6
发表时间：
2021-06
期刊：
The Lancet. Global health
影响因子：
--
作者：
Chmielewska B;Barratt I;Townsend R;Kalafat E;van der Meulen J;Gurol-Urganci I;O'Brien P;Morris E;Draycott T;Thangaratinam S;Le Doare K;Ladhani S;von Dadelszen P;Magee L;Khalil A
通讯作者：
Khalil A
影响因子：
17.7
作者：
Brunet, A;Weiss, DS;Marmar, CR
通讯作者：
Marmar, CR
影响因子：
4.6
作者：
Mayopoulos GA;Ein-Dor T;Li KG;Chan SJ;Dekel S
通讯作者：
Dekel S
影响因子：
1.5
作者：
Austin, Peter C.
通讯作者：
Austin, Peter C.