Perinatal factors related to post-traumatic stress disorder symptoms 1-5 years following birth
Perinatal factors related to post-traumatic stress disorder symptoms 1-5 years following birth
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DOI：
10.1016/j.wombi.2019.03.008
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发表时间：
2020-03-01
期刊：
影响因子：
3.8
通讯作者：
Miguel Martinez-Galiano, Juan
中科院分区：
文献类型：
--
作者：
Hernandez-Martinez, Antonio;Rodriguez-Almagro, Julian;Miguel Martinez-Galiano, Juan
背景：研究围产期变量与创伤后应激障碍（PTSD）症状的关系。然而，一些变量在PTSD症状中的作用尚不清楚。目的：了解产后1年后PTSD症状的患病率及其与围产期变量的关系。方法：对西班牙1531名产褥期妇女进行横断面研究。收集了有关社会人口统计学变量、围产期变量（产妇特征、分娩和分娩过程中的程序、分娩结果和出生后时间）和新生儿的数据。采用在线问卷，包括围产期创伤后应激问卷（PPQ）。采用二元逻辑回归计算粗比值比和校正比值比（OR）。结果：7.2%（110）的女性被确定有可能出现PTSD症状的风险。保护因素为遵守生育计划（aOR 0.44; 95%CI 0.19-0.99）、使用硬膜外镇痛（aOR 0.44; 95%CI 0.24-0.80）和皮肤接触（aOR 0.33; 95%CI 0.20-0.55）。危险因素为器械分娩（aOR 3.32; 95%CI1.73-3.39）、剖宫产（aOR 4.80; 95%CI 2.51-9.15）、接受基底压力（aOR 1.72; 95%CI 1.08-2.74）和会阴三/四度撕裂（aOR 2.73; 95%CI 1.27-5.86）。模型ROC曲线下面积为0.82 （95%CI 0.79 ~ 0.83）。结论：经历过正常分娩的妇女，对分娩有心理准备（例如，通过使用生育计划），与新生儿有皮肤对皮肤的接触，并通过使用硬膜外镇痛术有身体控制感，不太可能经历创伤性分娩。(C) 2019澳大利亚助产士学院。Elsevier Ltd.出版。版权所有。
Background: The relationship between perinatal variables and post-traumatic stress disorder (PTSD) symptoms was studied. However, the role of some variables in PTSD symptoms is unclear.Aim: Determine the prevalence of PTSD symptoms after 1 year postpartum and their relationship with perinatal variables.Methods: A cross-sectional study with 1531 puerperal women in Spain. Data were collected on sociodemographic variables, perinatal variables (maternal characteristics, procedures during labour and birth, birth outcomes and time since birth) and the newborn. An online questionnaire was used, which included the Perinatal Post-traumatic Stress Questionnaire (PPQ). Crude and adjusted odds ratios (OR) were calculated using binary logistic regression.Findings: 7.2% (110) of the women were identified as being at risk for probable PTSD symptoms. Protective factorswere having a birth plan respected (aOR 0.44; 95%CI 0.19-0.99), use of epiduralanalgesia (aOR 0.44; 95%CI 0.24-0.80) and experiencing skin-to-skin contact (aOR 0.33; 95%CI 0.20-0.55). Risk factors were instrumental birth (aOR 3.32; 95%CI1.73-3.39), caesarean section (aOR 4.80; 95%CI 2.51-9.15), receiving fundal pressure (aOR 1.72; 95%CI 1.08-2.74) and suffering a third/fourth degree perineal tear (aOR 2.73; 95%CI 1.27-5.86). The area under the model's ROC curve was 0.82 (95%CI 0.79-0.83).Conclusions: Women who experience a normal birth, are psychologically prepared for birth (for example, through use of a birth plan), experience skin-to-skin contact with their newborn, and had a sense of physical control through the use of epidural analgesia, are less likely to experience childbirth as traumatic. (C) 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.