Loveland Cook Cynthia A, Flick Louise H, Homan Sharon M, Campbell Claudia, McSweeney Maryellen, Gallagher Mary Elizabeth
Saint Louis University, School of Social Service, St Louis, Missouri 63103, USA.
Obstet Gynecol. 2004 Apr;103(4):710-7. doi: 10.1097/01.AOG.0000119222.40241.fb.
To estimate the prevalence of posttraumatic stress disorder and its treatment in economically disadvantaged pregnant women.
The sample included 744 pregnant Medicaid-eligible women from Women, Infants and Children Supplemental Nutrition Program sites in 5 counties in rural Missouri and the city of St. Louis. Race (black and white) was proportional to clients seen at each site. Women were assessed by using standardized measures of posttraumatic stress disorder, 18 other psychiatric disorders, environmental stressors, and pregnancy characteristics. Logistic regression identified risk factors associated with posttraumatic stress disorder.
Posttraumatic stress disorder prevalence was 7.7% (n = 57/744). Comorbid disorders were common. Women with posttraumatic stress disorder were 5 times more likely to have a major depressive episode (odds ratio 5.17; 95% confidence interval 2.61, 10.26) and more than 3 times as likely to have generalized anxiety disorder (odds ratio 3.25; 95% confidence interval 1.22, 8.62). Besides these comorbid disorders, risk factors for posttraumatic stress disorder included a history of maternal separation for 6 months and multiple traumatic events. Although most women with posttraumatic stress disorder reported moderate impairment in their daily lives, only 7 of the 57 women with this disorder reported speaking with any health professional about it in the last 12 months.
The prevalence of posttraumatic stress disorder in pregnancy and low treatment rates suggest that screening for this disorder should be considered in clinical practice.
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评估经济条件不利的孕妇中创伤后应激障碍（PTSD）的患病率及其治疗情况。
样本包括来自密苏里州农村5个县和圣路易斯市妇女、婴儿和儿童补充营养项目点的744名符合医疗补助条件的孕妇。种族（黑人和白人）与每个项目点的就诊客户比例相当。采用创伤后应激障碍、其他18种精神障碍、环境应激源和妊娠特征的标准化测量方法对女性进行评估。逻辑回归确定与创伤后应激障碍相关的危险因素。
创伤后应激障碍患病率为7.7%（n = 57/744）。共病很常见。患有创伤后应激障碍的女性发生重度抑郁发作的可能性高5倍（优势比5.17；95%置信区间2.61，10.26），患广泛性焦虑障碍的可能性高3倍多（优势比3.25；95%置信区间1.22，8.62）。除了这些共病，创伤后应激障碍的危险因素包括母亲分离6个月的病史和多次创伤事件。尽管大多数患有创伤后应激障碍的女性报告日常生活有中度损害，但在这57名患有该障碍的女性中，只有7人报告在过去12个月里与任何健康专业人员谈论过此事。
孕期创伤后应激障碍的患病率和低治疗率表明，临床实践中应考虑对此障碍进行筛查。
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