Srkalović Imširagić Azijada, Begić Dražen, Šimičević Livija, Bajić Žarko
Neuropsychiatric Hospital "Dr Ivan Barbot", Popovača, Croatia.
Department of Psychiatry, School of Medicine University of Zagreb, University Hospital Centre Zagreb, Zagreb, Croatia.
Women Birth. 2017 Feb;30(1):e17-e23. doi: 10.1016/j.wombi.2016.06.007. Epub 2016 Jul 12.
Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder.
Using a biopsychosocial model, the primary aim of this study was to identify predictors of posttraumatic stress disorder and its symptomatology following childbirth.
This observational, longitudinal study included 372 postpartum women. In order to explore biopsychosocial predictors, participants completed several questionnaires 3-5 days after childbirth: the Impact of Events Scale Revised, the Big Five Inventory, The Edinburgh Postnatal Depression Scale, breastfeeding practice and social and demographic factors. Six to nine weeks after childbirth, participants re-completed the questionnaires regarding psychiatric symptomatology and breastfeeding practice.
Using a multivariate level of analysis, the predictors that increased the likelihood of postpartum posttraumatic stress disorder symptomatology at the first study phase were: emergency caesarean section (odds ratio 2.48; confidence interval 1.13-5.43) and neuroticism personality trait (odds ratio 1.12; confidence interval 1.05-1.20). The predictor that increased the likelihood of posttraumatic stress disorder symptomatology at the second study phase was the baseline Impact of Events Scale Revised score (odds ratio 12.55; confidence interval 4.06-38.81). Predictors that decreased the likelihood of symptomatology at the second study phase were life in a nuclear family (odds ratio 0.27; confidence interval 0.09-0.77) and life in a city (odds ratio 0.29; confidence interval 0.09-0.94).
Biopsychosocial theory is applicable to postpartum psychiatric disorders. In addition to screening for depression amongst postpartum women, there is a need to include other postpartum psychiatric symptomatology screenings in routine practice.
分娩后，大量女性会经历一定程度的情绪波动，而一些女性会出现产后创伤后应激障碍的症状。
本研究的主要目的是使用生物心理社会模型，确定分娩后创伤后应激障碍及其症状的预测因素。
这项观察性纵向研究纳入了372名产后女性。为了探索生物心理社会预测因素，参与者在分娩后3至5天完成了几份问卷：事件影响量表修订版、大五人格量表、爱丁堡产后抑郁量表、母乳喂养情况以及社会和人口统计学因素。分娩后6至9周，参与者再次完成了关于精神症状和母乳喂养情况的问卷。
在多变量分析层面，在第一个研究阶段增加产后创伤后应激障碍症状发生可能性的预测因素为：急诊剖宫产（比值比2.48；置信区间1.13 - 5.43）和神经质人格特质（比值比1.12；置信区间1.05 - 1.20）。在第二个研究阶段增加创伤后应激障碍症状发生可能性的预测因素是事件影响量表修订版的基线得分（比值比12.55；置信区间4.06 - 38.81）。在第二个研究阶段降低症状发生可能性的预测因素是核心家庭生活（比值比0.27；置信区间0.09 - 0.77）和城市生活（比值比0.29；置信区间0.09 - 0.94）。
生物心理社会理论适用于产后精神障碍。除了对产后女性进行抑郁筛查外，在常规实践中还需要纳入其他产后精神症状筛查。
