Arch Womens Ment Health. 2013 Dec;16(6):453-63. doi: 10.1007/s00737-013-0365-8.
Changes in mental health symptoms throughout pregnancy and postpartum may impact a woman's experience and adjustment during an important time. However, few studies have investigated these changes throughout the perinatal period, particularly changes in posttraumatic stress disorder (PTSD) symptoms. The purpose of this study was to examine longitudinal changes in PTSD, depression, and anxiety symptomatology during pregnancy and postpartum. Pregnant women of ethnically diverse backgrounds receiving services for prenatal care at an outpatient obstetric-gynecology clinic or private physicians' office were assessed by interview on symptoms of PTSD, depression, anxiety, and general stress up to four times, including their first, second, and third trimester, and postpartum visits. Overall, during pregnancy there was a declining trend of PTSD symptoms. For anxiety, there was no overall significant change over time; however, anxiety symptoms were individually variable in the rate of change. For both depression and general stress symptoms, there was a declining trend, which was also variable in the individual rate of change among women during their pregnancy. Visual and post hoc analyses also suggest a possible peak in PTSD symptoms in the weeks prior to delivery. While most mental health symptoms may generally decrease during pregnancy, given the individual variability among women in the rate of change in symptoms, screening and monitoring of symptom fluctuations throughout the course of pregnancy may be needed. Further studies are needed to examine potential spiking of symptoms in the perinatal period.
怀孕期间和产后心理健康症状的变化可能会影响女性在重要时期的体验和适应能力。然而,很少有研究调查整个围产期的这些变化,特别是创伤后应激障碍(PTSD)症状的变化。本研究的目的是探讨怀孕期间和产后 PTSD、抑郁和焦虑症状的纵向变化。在妇产科门诊或私人医生办公室接受产前保健服务的不同种族背景的孕妇通过访谈评估 PTSD、抑郁、焦虑和一般压力症状,最多评估 4 次,包括第一次、第二次和第三次孕期以及产后访视。总的来说,怀孕期间 PTSD 症状呈下降趋势。对于焦虑,随时间没有整体显著变化;然而,焦虑症状在变化率上是个体差异的。对于抑郁和一般压力症状,也呈下降趋势,女性在怀孕期间的变化率也存在个体差异。视觉和事后分析还表明,分娩前几周 PTSD 症状可能出现峰值。虽然大多数心理健康症状在怀孕期间可能普遍减轻,但鉴于女性在症状变化率方面存在个体差异,可能需要在整个怀孕期间筛查和监测症状波动。需要进一步研究以检查围产期症状的潜在峰值。