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羊膜穿刺术、产妇精神病理学与产前依恋表象:一项前瞻性对比研究。

Amniocentesis, maternal psychopathology and prenatal representations of attachment: a prospective comparative study.

机构信息

Clinique Psychiatrique Universitaire, CHRU de Tours, France.

出版信息

PLoS One. 2012;7(7):e41777. doi: 10.1371/journal.pone.0041777. Epub 2012 Jul 25.

Abstract

BACKGROUND

The aim of the study was to characterize the maternal dimensions of anxiety, depression and prenatal attachment in women undergoing an amniocentesis.

METHODOLOGY/PRINCIPAL FINDINGS: A prospective observational study was conducted. Women were referred to early amniocentesis for increased nuchal translucency, elevated biochemical markers or advanced maternal age. All participants had 3 prenatal (16-18, 20-24, 30-34 weeks of gestation) and one postnatal (30-45 days) interviews reviewing for demographic, medical, and psychiatric information (STAI State-Trait Anxiety Inventory; EPDS: Edinburgh Postnatal Depression Scale; IRMAG: Interview of Maternal Representations of Attachment during pregnancy). We investigated 232 pregnant women who undergone an amniocentesis compared with 160 pregnant controls. Following the procedure, the amniocentesis group experienced transiently significantly higher levels of state-anxiety on the STAI (44.6 vs. 39.3) and depression as measured by the EPDS (9.4 vs. 6.3) than the controls. Overall in both groups, the maternal representations of attachment were well integrated and balanced, but the amniocentesis group experienced significantly more mother-directed representations.

CONCLUSIONS/SIGNIFICANCE: Amniocentesis is associated with higher affective adaptive reactions that tend to normalize during the pregnancy, with overall preserved maternal fetal representations of attachment.

摘要

背景

本研究旨在描述行羊膜穿刺术孕妇的焦虑、抑郁和产前依恋的母婴维度。

方法/主要发现:本研究采用前瞻性观察研究。孕妇因颈项透明层增厚、生化标志物升高或高龄而被转至早期羊膜穿刺术。所有参与者在产前(16-18 周、20-24 周、30-34 周)和产后(30-45 天)接受 3 次访谈,以回顾人口统计学、医学和精神科信息(STAI 状态-特质焦虑量表;EPDS:爱丁堡产后抑郁量表;IRMAG:孕期母婴依恋访谈)。我们共调查了 232 名接受羊膜穿刺术的孕妇,并与 160 名对照孕妇进行了比较。在该操作后,羊膜穿刺术组在 STAI 上的状态焦虑评分(44.6 分比 39.3 分)和 EPDS 上的抑郁评分(9.4 分比 6.3 分)均显著高于对照组。在两组中,母婴依恋的代表总体上都是良好的整合和平衡的,但羊膜穿刺术组表现出更明显的母婴指向性的代表。

结论/意义:羊膜穿刺术与更高的情感适应反应相关,这些反应在怀孕期间趋于正常,母婴依恋的总体代表保持不变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f32/3404955/aa39e80805f6/pone.0041777.g001.jpg

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