Polachek Inbal Shlomi, Harari Liat Huller, Baum Micha, Strous Rael D
Beer Yaakov Mental Health Center, Beer Yaakov, Israel.
Isr Med Assoc J. 2012 Jun;14(6):347-53.
While many are familiar with postpartum depression, the phenomenon of postpartum post-traumatic stress disorder (PTSD) is less well known and investigated.
To assess the prevalence of postpartum PTSD in a cohort of women in Israel and examine factors affecting its development.
Eighty-nine women completed several ratings immediately post-delivery and after a month. Factors examined related to the pregnancy, childbirth expectations, and delivery. Rating scales comprised evaluations of attachment, personality, PTSD, and demographic variables.
The prevalence of post-partum PTSD was 3.4% (complete PTSD), 7.9% nearly complete PTSD, and 25.9% significant partial disorder. Women who developed PTSD symptoms had a higher prevalence of "traumatic" previous childbirth, with subsequent depression and anxiety. They also reported more medical complications and "mental crises" during pregnancy as well as anticipating more childbirth pain and fear. Instrumental or cesarean deliveries were not associated with PTSD. Most of the women who developed PTSD symptoms delivered vaginally, but received fewer analgesics with stronger reported pain. Women with PTSD reported more discomfort with the undressed state, stronger feelings of danger, and higher rates of not wanting additional children.
The study results indicate the importance of inquiring about previous pregnancy and birthing experiences and the need to identify at-risk populations and increased awareness of the disorder. The importance of addressing anticipatory concerns of pain prior to delivery as well as respecting dignity and minimizing the undressed state during childbirth should not be underestimated. A short questionnaire following childbirth may enable rapid identification of symptoms relevant to PTSD.
虽然许多人熟悉产后抑郁症，但产后创伤后应激障碍（PTSD）现象却鲜为人知且研究较少。
评估以色列一组女性中产后创伤后应激障碍的患病率，并研究影响其发生发展的因素。
89名女性在分娩后即刻和产后一个月完成了多项评分。所研究的因素涉及怀孕、分娩期望和分娩情况。评分量表包括依恋、人格、创伤后应激障碍和人口统计学变量的评估。
产后创伤后应激障碍的患病率为3.4%（完全创伤后应激障碍），7.9%为接近完全创伤后应激障碍，25.9%为显著部分障碍。出现创伤后应激障碍症状的女性，既往有“创伤性”分娩史、随后出现抑郁和焦虑的患病率更高。她们还报告在孕期有更多的医疗并发症和“精神危机”，以及预期有更多的分娩疼痛和恐惧。器械助产或剖宫产与创伤后应激障碍无关。大多数出现创伤后应激障碍症状的女性经阴道分娩，但使用的镇痛药较少且报告的疼痛更强。患有创伤后应激障碍的女性报告在未着装状态下更不适、有更强的危险感以及不想要更多孩子的比例更高。
研究结果表明询问既往怀孕和分娩经历的重要性，以及识别高危人群和提高对该疾病认识的必要性。不应低估在分娩前解决对疼痛的预期担忧以及尊重尊严并尽量减少分娩时未着装状态的重要性。产后一份简短问卷可能有助于快速识别与创伤后应激障碍相关的症状。
