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[分娩疼痛、围产期解离及围产期困扰作为创伤后应激症状的预测因素]

[Childbirth pain, perinatal dissociation and perinatal distress as predictors of posttraumatic stress symptoms].

作者信息

Boudou M, Séjourné N, Chabrol H

机构信息

Centre d'Etudes et de Recherches en Psychopathologie, Université de Toulouse-II-le Mirail, 5, Allée Antonio-Machado, 31058, Toulouse, France.

出版信息

Gynecol Obstet Fertil. 2007 Nov;35(11):1136-42. doi: 10.1016/j.gyobfe.2007.09.014. Epub 2007 Nov 8.

Abstract

OBJECTIVE

This prospective, longitudinal study investigated the contributive role of childbirth pain, perinatal distress and perinatal dissociation to the development of PTSD symptoms following childbirth.

PATIENTS AND METHODS

One hundred and seventeen women participated at the study. The first day after delivery they completed a questionnaire to evaluate pain, the peritraumatic distress inventory (PDI) and the peritraumatic dissociative experience questionnaire (PDEQ). Six weeks after birth, they completed the impact of event scale-revised (IES-R) to measure posttraumatic stress symptoms and the Edinburgh Postnatal Depression Scale (EPDS) to assess maternal depression.

RESULTS

A multiple regression analysis revealed that only both components of perinatal distress, life-threat perception and dysphoric emotions were significant predictors of posttraumatic stress symptoms. In another multiple regression analysis predicting dysphoric emotions, affective dimension of pain was the only significant predictor.

DISCUSSION AND CONCLUSION

Perinatal distress was the best predictor of posttraumatic stress symptoms. Dysphoric emotions were associated with affective dimension of pain, suggesting that women distressed by the childbirth pain would have higher risk to develop posttraumatic stress symptoms.

摘要

目的

这项前瞻性纵向研究调查了分娩疼痛、围产期困扰和围产期分离对产后创伤后应激障碍(PTSD)症状发展的作用。

患者与方法

117名女性参与了该研究。分娩后第一天,她们完成了一份评估疼痛的问卷、创伤时困扰量表(PDI)和创伤时分离体验问卷(PDEQ)。产后六周,她们完成了事件影响量表修订版(IES-R)以测量创伤后应激症状,以及爱丁堡产后抑郁量表(EPDS)以评估产妇抑郁。

结果

多元回归分析显示,只有围产期困扰的两个组成部分,即生命威胁感知和烦躁情绪,是创伤后应激症状的显著预测因素。在另一个预测烦躁情绪的多元回归分析中,疼痛的情感维度是唯一的显著预测因素。

讨论与结论

围产期困扰是创伤后应激症状的最佳预测因素。烦躁情绪与疼痛的情感维度相关,这表明因分娩疼痛而困扰的女性发生创伤后应激症状的风险更高。

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