Kashiwagi Maki, Sieber Sandra, Rechsteiner Chantal, Lauper Urs, Zimmermann Roland, Ehlert Ulrike
Department of Obstetrics & Gynecology, Clinic of Obstetrics, University Hospital Zurich, Switzerland.
J Psychosom Obstet Gynaecol. 2007 Mar;28(1):3-6. doi: 10.1080/01674820601058104.
Opiate addiction has been widely documented to have a negative impact on pregnancy course and outcome. The unfavorable psychosocial situation of addicted women predispose for poor processing of the physiological and psychological demands of pregnancy. Thus the aim of our study was to investigate the psychological mood state of opiate addicts during pregnancy and postpartum in comparison to healthy women. In a case-controlled, prospective, longitudinal study, nine pregnant opiate addicts and nine healthy pregnant women matched by age, level of education and gestational age at birth were interviewed in the third trimester of pregnancy and postpartum. Standardized questionnaires and inventories for assessment of the general psychopathology and emotional state, the perceived self-efficacy expectancy, the psychosocial adaptation to pregnancy and the fear of delivery, respectively were applied. Addicted women achieved significantly higher scores in the test assessing general psychopathology and emotional state before delivery compared to abstinent women. Interestingly this difference was unverifiable postpartum. This study reaffirms the presumption of a disadvantageous psychological condition in pregnant opiate addicts in comparison to healthy pregnant women for the first time in a prospective case-control study design.
阿片类药物成瘾对妊娠过程和结局有负面影响,这已被广泛记录。成瘾女性不利的心理社会状况使其难以应对妊娠的生理和心理需求。因此,我们研究的目的是对比健康女性,调查阿片类药物成瘾者在孕期和产后的心理情绪状态。在一项病例对照、前瞻性纵向研究中,选取了9名孕期阿片类药物成瘾孕妇和9名年龄、教育水平及出生孕周相匹配的健康孕妇,在妊娠晚期和产后进行访谈。分别应用标准化问卷和量表评估一般精神病理学和情绪状态、自我效能预期、对妊娠的心理社会适应以及分娩恐惧。与未成瘾女性相比,成瘾女性在分娩前评估一般精神病理学和情绪状态的测试中得分显著更高。有趣的是,产后这种差异无法证实。本研究在前瞻性病例对照研究设计中首次重申了与健康孕妇相比,孕期阿片类药物成瘾者存在不利心理状况的推测。