Horsch Antje, Brooks Chloe, Fletcher Helen
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (SUPEA), Unité de Recherche, Université de Lausanne, Lausanne, Switzerland; Service de Néonatologie, Université de Lausanne, Lausanne, Switzerland.
Prenat Diagn. 2013 Dec;33(12):1137-45. doi: 10.1002/pd.4207. Epub 2013 Sep 3.
So far, associations between appraisals, maternal adjustment and coping following diagnosis of fetal anomaly have not been investigated in women who continue with their pregnancy.
This study measured maternal coping and adjustment after and appraisal of a diagnosis of fetal anomaly in 40 mothers who had continued with their pregnancy using a cross-sectional questionnaire design.
Based on retrospective reporting, 35% of participants met full diagnostic criteria for post-traumatic stress disorder after having received the diagnosis. Women were significantly more depressed (p < 0.001) and anxious (p < 0.001) and reported significantly less positive affect (p < 0.05) after having received the diagnosis in comparison to the time after childbirth. There were no significant differences between emotion-focused and problem-focused coping. Stressful life events, women's age, number of people providing support and problem-focused coping explained 57.6% of variance in anxiety and depression after childbirth. Satisfaction with social support, emotion-focused coping and problem-focused coping significantly explained 40.6% of variance in positive affect after childbirth.
Following a prenatal diagnosis and for the remainder of their pregnancy, particular attention should be paid to older mothers, those experiencing additional stressful life events and those who are socially isolated, as these women may experience greater distress after childbirth.
迄今为止,尚未对继续妊娠的女性在胎儿异常诊断后的评估、母亲适应及应对之间的关联进行研究。
本研究采用横断面问卷调查设计,对40名继续妊娠的母亲在胎儿异常诊断后的应对及适应情况进行了测量。
根据回顾性报告,35%的参与者在收到诊断后符合创伤后应激障碍的全部诊断标准。与产后相比,女性在收到诊断后抑郁程度显著更高(p < 0.001),焦虑程度显著更高(p < 0.001),且积极情绪显著更少(p < 0.05)。聚焦情绪应对和聚焦问题应对之间无显著差异。压力性生活事件、女性年龄、提供支持的人数以及聚焦问题应对解释了产后焦虑和抑郁变异的57.6%。对社会支持的满意度、聚焦情绪应对和聚焦问题应对显著解释了产后积极情绪变异的40.6%。
在产前诊断后及妊娠剩余时间里,应特别关注年龄较大的母亲、经历额外压力性生活事件的母亲以及社会孤立的母亲,因为这些女性在产后可能会经历更大的痛苦。