Defining postpartum PTSD and its implications for maternal wellness and child development
定义产后创伤后应激障碍及其对孕产妇健康和儿童发展的影响
基本信息
- 批准号:10521680
- 负责人:
- 金额:$ 66.79万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-08-16 至 2027-07-31
- 项目状态:未结题
- 来源:
- 关键词:AccidentsAddressAffectAmericanAmerican College of Obstetricians and GynecologistsAnimal ModelBehavioralBiologicalBiological MarkersBirthBreastfed infantCaringChildChild DevelopmentChild WelfareChildbirthChronicClinicalCognitionCognitiveCommunicationDSM-VDataDevelopmentDiagnosisDimensionsDiscipline of obstetricsDiseaseEarly InterventionEmotionalEnhancersEpigenetic ProcessExposure toFoundationsGoalsGrowthHealthHourImageryImpairmentInfantInvestigationKnowledgeLifeLongitudinal prospective studyMaternal DeprivationMaternal HealthMaternal MortalityMeasurementMeasuresMediatingMedicalMedical RecordsMental DepressionMental HealthMental Health ServicesMental disordersMilitary PersonnelMinority WomenMissionModificationMorbidity - disease rateMother-Child RelationsMothersMotorNational Institute of Child Health and Human DevelopmentNeurotic DisordersOutcomePerceptionPerinatalPhysiologicalPost-Traumatic Stress DisordersPostpartum DepressionPostpartum PeriodPregnancyPregnant WomenPreventiveProceduresProviderPsyche structurePsychometricsPsychopathologyPsychophysiologyQuality of CareReproductive ProcessRiskRisk FactorsRoleScheduleSecuritySocial supportStandardizationStressSymptomsTestingTherapeutic InterventionThird Pregnancy TrimesterTimeTraumaValidationWell in selfWomanWorkantenatalassaultcohortcombatcostearly screeningemotional distressexperienceimprovedinfant temperamentinsightintergenerationallow socioeconomic statusmaternal morbiditymental imageryneonatal periodobstetrical complicationpatient stratificationprepregnancypreventprogramsprospectiveprotective factorspsychologicpublic health relevanceracial and ethnicracial discriminationracial health disparityresponsescreeningsocial determinantssocietal costsstemstressortherapeutic candidatetooltrauma exposuretraumatic eventtraumatic stresswelfare
项目摘要
PROJECT SUMMARY. Maternal mental illness following childbirth is associated with substantial societal costs.
Postpartum psychopathology is a leading contributor of maternal morbidity and mortality and can endanger the
child’s wellbeing onward from birth. Deprivation of maternal care during the early neonatal period can induce
long-term epigenetic alterations in a model animal, suggesting that postpartum mental illness can confer
intergenerational risks. While efforts exist to reduce postpartum depression, childbirth-related posttraumatic
stress disorder (CB-PTSD), a condition that is estimated to affect 240,000 American women each year, is
underdiagnosed and undertreated. Risk factors for CB-PTSD remain elusive, and knowledge about the
disorder’s course and impact on the child is almost entirely lacking. By generating important and substantive
data, the central objective of this proposal is to serve as a first step towards addressing the clinical gap for a
condition that should be amenable to early intervention.
In this first of its kind longitudinal prospective study, we will study pregnant women during third trimester (Wk.
32), again in the hours following delivery and will follow them at repeated time points across the postpartum (PP)
year, i.e., Day 1, Day 45, and Mos. 3, 6, and 12. Their infants will be studied at Mo. 6 and Mo. 12 PP. This
schedule will allow us to examine risk for, and development of, CB-PTSD, as well as its influence on mother-
infant bonding and early child development. Maternal CB-PTSD will be quantified using psychodiagnostic,
psychometric, and psychophysiologic measures. Psychophysiological responsivity during mental imagery of the
traumatic childbirth provides a potentially reliable biological marker of PTSD and can provide objective validation
of the CB-PTSD diagnosis. Bonding will be quantified using psychometric assessments of maternal perceptions
and an observational assessment of mother-child interaction at 6 mos. PP. Child outcomes will be quantified
using a standardized child developmental observational procedure and standardized psychometrics at 12 mos.
This study will offer new insights into the previously understudied posttraumatic dimension of postpartum
psychopathology. Our work could suggest modifications of postpartum mental health care, which currently
focuses on depression. Our findings may inform tools that can be used for early screening that may be the first
step in implementing programs that can enhance the welfare of mother and child, thereby reducing the odds of
developing a potentially preventable, costly posttraumatic disorder. In addition, the proposed study will further
the NICHD missions that “women avoid harmful effects from reproductive processes and children achieve
healthy and productive lives”.
项目摘要。产妇分娩后的精神疾病与巨大的社会成本有关。
产后精神病理学是孕产妇发病率和死亡率的主要原因,
孩子的幸福从出生开始。在新生儿早期缺乏产妇护理可能会导致
模型动物的长期表观遗传改变,表明产后精神疾病可以赋予
代际风险。虽然人们努力减少产后抑郁症,但与分娩有关的创伤后
应激障碍(CB-PTSD),一种估计每年影响24万美国妇女的疾病,
诊断和治疗不足CB-PTSD的风险因素仍然难以捉摸,关于CB-PTSD的知识
疾病的过程和对孩子的影响几乎完全缺乏。通过产生重要和实质性的
数据,该提案的中心目标是作为解决临床差距的第一步,
这种情况应该及早干预。
在这项首次纵向前瞻性研究中,我们将研究妊娠晚期的孕妇(Wk.
32),在分娩后的几个小时内再次进行,并将在产后(PP)的重复时间点进行随访
年,即第一天,第45天,Mos。3、6和12。他们的孩子将在莫进行研究。6、莫12 PP。这
时间表将使我们能够检查CB-PTSD的风险和发展,以及它对母亲的影响-
婴儿亲密关系和儿童早期发展。将使用心理诊断,
心理测量和心理生理测量。心理意象的心理生理反应
创伤性分娩为PTSD提供了一个潜在可靠的生物学标志,并可提供客观的验证
CB-PTSD的诊断将使用母亲感知的心理测量评估来量化结合
以及在6个月时对母婴相互作用的观察评估。PP.将量化儿童成果
在12个月时使用标准化儿童发育观察程序和标准化心理测量学。
这项研究将为以前研究不足的产后创伤后维度提供新的见解。
精神病理学我们的工作可以建议修改产后心理健康护理,目前
专注于抑郁症。我们的发现可能会告知可用于早期筛查的工具,
采取措施,实施可以提高母亲和儿童福利的方案,从而减少
发展成一种潜在的可预防的代价高昂的创伤后精神障碍此外,拟议的研究将进一步
NICHD的使命是“妇女避免生殖过程的有害影响,儿童实现
健康和富有成效的生活”。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Sharon Dekel其他文献
Sharon Dekel的其他文献
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{{ truncateString('Sharon Dekel', 18)}}的其他基金
The effects of expressive writing following traumatic childbirth
创伤性分娩后表达性写作的影响
- 批准号:
10592883 - 财政年份:2023
- 资助金额:
$ 66.79万 - 项目类别:
Defining postpartum PTSD and its implications for maternal wellness and child development
定义产后创伤后应激障碍及其对孕产妇健康和儿童发展的影响
- 批准号:
10684813 - 财政年份:2022
- 资助金额:
$ 66.79万 - 项目类别:
Neural underpinnings of postpartum adaptation following traumatic delivery and implications for infant development
创伤性分娩后产后适应的神经基础及其对婴儿发育的影响
- 批准号:
9979427 - 财政年份:2020
- 资助金额:
$ 66.79万 - 项目类别:
Neural underpinnings of postpartum adaptation following traumatic delivery and implications for infant development
创伤性分娩后产后适应的神经基础及其对婴儿发育的影响
- 批准号:
10330226 - 财政年份:2020
- 资助金额:
$ 66.79万 - 项目类别:
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