The influence of women's preferences and actual mode of delivery on post-traumatic stress symptoms following childbirth: a population-based, longitudinal study.
The influence of women's preferences and actual mode of delivery on post-traumatic stress symptoms following childbirth: a population-based, longitudinal study.
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妇女偏好和实际分娩方式对分娩后创伤后应激症状的影响：一项基于人群的纵向研究。
DOI：
10.1186/1471-2393-14-191
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发表时间：
2014-06-05
影响因子：
3.1
通讯作者：
Eberhard-Gran M
中科院分区：
文献类型：
--
作者：
Garthus-Niegel S;von Soest T;Knoph C;Simonsen TB;Torgersen L;Eberhard-Gran M
这项研究旨在调查女性首选的分娩方式和实际分娩方式之间的不匹配是否会增加分娩后出现创伤后应激症状的风险。研究样本包括1700名计划在2009至2010年间在挪威阿克舒斯大学医院分娩的女性。问卷数据来自怀孕17周和32周，以及产后8周，与从医院出生记录中获得的数据一起使用。创伤后应激症状采用事件影响量表测评。根据妇女的首选和实际分娩方式，确定了四组：匹配1(不喜欢剖宫产，不选择剖宫产，N = 1,493)；匹配2(首选剖宫产，选择剖宫产，N = 53)；不匹配1(不喜欢剖宫产，选择剖腹产，N = 42)；不匹配2(首选剖宫产，不选择剖宫产，N = 112)。用方差分析(ANOVA)和协方差分析(ANCOVA)来检验创伤后应激症状水平在这四组之间是否有显著差异。检验所有四组的差异，单因素方差分析得到显著的总体组差异(F = 11.96，p <； 0.001)。然而，Bonferroni的事后测试发现，只有在不匹配2的情况下，创伤后应激症状的水平显著高于匹配1。这种差异可以部分解释为一些风险因素，特别是心理风险因素，如害怕分娩、抑郁和焦虑。结果表明，与既喜欢阴道分娩又喜欢阴道分娩的女性相比，喜欢剖腹产但通过阴道分娩的女性创伤后应激症状增加。在心理脆弱的女性中，这种不匹配可能会威胁到她们的身体完整性，进而导致创伤后应激症状。这些经常害怕分娩的女性可能更喜欢剖腹产，尽管在没有医学指征的情况下，阴道分娩通常是最好的选择。为了避免潜在的创伤，对分娩的恐惧和产妇要求剖腹产的要求应该得到认真对待并得到充分的回应。
This study aimed to examine whether a mismatch between a woman’s preferred and actual mode of delivery increases the risk of post-traumatic stress symptoms after childbirth. The study sample consisted of 1,700 women scheduled to give birth between 2009 and 2010 at Akershus University Hospital, Norway. Questionnaire data from pregnancy weeks 17 and 32 and from 8 weeks postpartum were used along with data obtained from hospital birth records. Post-traumatic stress symptoms were measured with the Impact of Event Scale. Based on the women’s preferred and actual mode of delivery, four groups were established: Match 1 (no preference for cesarean section, no elective cesarean section, N = 1,493); Match 2 (preference for cesarean section, elective cesarean section, N = 53); Mismatch 1 (no preference for cesarean section, elective cesarean section, N = 42); and Mismatch 2 (preference for cesarean section, no elective cesarean section, N = 112). Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were conducted to examine whether the level of post-traumatic stress symptoms differed significantly among these four groups. Examining differences for all four groups, ANOVA yielded significant overall group differences (F = 11.96, p < 0.001). However, Bonferroni post-hoc tests found significantly higher levels of post-traumatic stress symptoms only in Mismatch 2 compared to Match 1. This difference could be partly explained by a number of risk factors, particularly psychological risk factors such as fear of childbirth, depression, and anxiety. The results suggest increased post-traumatic stress symptoms in women who preferred delivery by cesarean section but delivered vaginally compared to women who both preferred vaginal delivery and delivered vaginally. In psychologically vulnerable women, such mismatch may threaten their physical integrity and, in turn, result in post-traumatic stress symptoms. These women, who often fear childbirth, may prefer a cesarean section even though vaginal delivery is usually the best option in the absence of medical indications. To avoid potential trauma, fear of childbirth and maternal requests for a cesarean section should be taken seriously and responded to adequately.
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DOI：
10.1111/j.1471-0528.2010.02793.x
发表时间：
2011-03
期刊：
BJOG : an international journal of obstetrics and gynaecology
影响因子：
--
作者：
Mazzoni A;Althabe F;Liu NH;Bonotti AM;Gibbons L;Sánchez AJ;Belizán JM
通讯作者：
Belizán JM
影响因子：
3.6
作者：
Donnellan, M. Brent;Oswald, Frederick L.;Lucas, Richard E.
通讯作者：
Lucas, Richard E.
影响因子：
2.5
作者：
Nerum, Hilde;Halvorsen, Lotta;Oian, Pal
通讯作者：
Oian, Pal
影响因子：
4.5
作者：
Garthus-Niegel, Susan;von Soest, Tilmann;Eberhard-Gran, Malin
通讯作者：
Eberhard-Gran, Malin
影响因子：
3.1
作者：
Czarnocka, J;Slade, P
通讯作者：
Slade, P