School of Nursing, University of Connecticut, Storrs, USA.
Birth. 2011 Sep;38(3):216-27. doi: 10.1111/j.1523-536X.2011.00475.x. Epub 2011 May 20.
Prevalence rates of women in community samples who screened positive for meeting the DSM-IV criteria for posttraumatic stress disorder after childbirth range from 1.7 to 9 percent. A positive screen indicates a high likelihood of this postpartum anxiety disorder. The objective of this analysis was to examine the results that focus on the posttraumatic stress disorder data obtained from a two-stage United States national survey conducted by Childbirth Connection: Listening to Mothers II (LTM II) and Listening to Mothers II Postpartum Survey (LTM II/PP).
In the LTM II study, 1,373 women completed the survey online, and 200 mothers were interviewed by telephone. The same mothers were recontacted and asked to complete a second questionnaire 6 months later and of those, 859 women completed the online survey and 44 a telephone interview. Data obtained from three instruments are reported in this article: Posttraumatic Stress Disorder Symptom Scale-Self Report (PSS-SR), Postpartum Depression Screening Scale (PDSS), and the Patient Health Questionnaire-2 (PHQ-2).
Nine percent of the sample screened positive for meeting the diagnostic criteria of posttraumatic stress disorder after childbirth as determined by responses on the PSS-SR. A total of 18 percent of women scored above the cutoff score on the PSS-SR, which indicated that they were experiencing elevated levels of posttraumatic stress symptoms. The following variables were significantly related to elevated posttraumatic stress symptoms levels: low partner support, elevated postpartum depressive symptoms, more physical problems since birth, and less health-promoting behaviors. In addition, eight variables significantly differentiated women who had elevated posttraumatic stress symptom levels from those who did not: no private health insurance, unplanned pregnancy, pressure to have an induction and epidural analgesia, planned cesarean birth, not breastfeeding as long as wanted, not exclusively breastfeeding at 1 month, and consulting with a clinician about mental well-being since birth. A stepwise multiple regression revealed that two predictor variables significantly explained 55 percent of the variance in posttraumatic stress symptom scores: depressive symptom scores on the PHQ-2 and total number of physical symptoms women were experiencing at the time they completed the LTM II/PP survey.
In this two-stage national survey the high percentage of mothers who screened positive for meeting all the DSM-IV criteria for a posttraumatic stress disorder diagnosis is a sobering statistic.
在社区样本中，产后筛查符合 DSM-IV 创伤后应激障碍标准的女性患病率为 1.7%至 9%。阳性筛查表明这种产后焦虑症的可能性很高。本分析的目的是检查专注于通过由 Childbirth Connection 进行的两阶段美国全国性调查（生育连接：倾听母亲 II（LTM II）和倾听母亲 II 产后调查（LTM II/PP））获得的创伤后应激障碍数据的结果。
在 LTM II 研究中，1373 名女性在线完成了调查，200 名母亲接受了电话采访。对同一批母亲进行了重新联系，并要求她们在 6 个月后完成第二个问卷，其中 859 名女性在线完成了调查，44 名女性接受了电话采访。本文报告了三种工具获得的数据：创伤后应激障碍症状量表自我报告（PSS-SR）、产后抑郁筛查量表（PDSS）和患者健康问卷-2（PHQ-2）。
根据 PSS-SR 的回答，9%的样本筛查出产后创伤后应激障碍的诊断标准阳性。共有 18%的女性在 PSS-SR 上的得分超过了临界值，这表明她们经历了较高水平的创伤后应激症状。以下变量与较高的创伤后应激症状水平显著相关：伴侣支持低、产后抑郁症状升高、产后出现更多身体问题、促进健康的行为减少。此外，八个变量显著区分了有较高创伤后应激症状水平的女性和没有的女性：没有私人医疗保险、意外怀孕、压力进行诱导和硬膜外镇痛、计划剖腹产、不能按照自己的意愿母乳喂养、不能在 1 个月时纯母乳喂养、以及自出生以来向临床医生咨询心理健康问题。逐步多元回归显示，两个预测变量显著解释了创伤后应激症状评分的 55%的方差：PHQ-2 上的抑郁症状评分和女性在完成 LTM II/PP 调查时经历的身体症状总数。
在这项两阶段全国性调查中，筛查出符合 DSM-IV 创伤后应激障碍所有标准的母亲比例很高，这是一个令人警醒的统计数据。
