Dekel Sharon, Stuebe Caren, Dishy Gabriella
Department of Psychiatry, Harvard Medical SchoolBoston, MA, USA.
Department of Psychiatry, Massachusetts General HospitalCharlestown, MA, USA.
Front Psychol. 2017 Apr 11;8:560. doi: 10.3389/fpsyg.2017.00560. eCollection 2017.
Posttraumatic stress related with the childbirth experience of full-term delivery with health outcomes has been recently documented in a growing body of studies. The magnitude of this condition and the factors that might put a woman at risk for developing childbirth-related postpartum posttraumatic stress disorder (PP-PTSD) symptoms are not fully understood. In this systematic review of 36 articles representing quantitative studies of primarily community samples, we set to examine PP-PTSD prevalence rates and associated predictors with a focus on the role of prior PTSD and time since childbirth. A significant minority of women endorsed PP-PTSD following successful birth. Acute PP-PTSD rates were between 4.6 and 6.3%, and endorsement of clinically significant PP-PTSD symptoms was identified in up to 16.8% of women in community samples of high quality studies. Negative subjective experience of childbirth emerged as the most important predictor. Endorsement of PTSD before childbirth contributed to PP-PTSD; nevertheless, women without PTSD also exhibited PP-PTSD, with acute rates at 4.6%, signifying a new PTSD onset in the postpartum period. Although the majority of women cope well, childbirth for some can be perceived as a highly stressful experience and even result in the development of PP-PTSD symptoms. More research is needed to understand postpartum adaption and childbirth-related posttraumatic stress outcomes.
近期越来越多的研究记录了与足月分娩的分娩经历相关的创伤后应激及其健康后果。这种情况的严重程度以及可能使女性面临分娩相关产后创伤后应激障碍(PP-PTSD)症状风险的因素尚未完全明确。在这项对36篇主要代表社区样本定量研究的文章进行的系统综述中,我们旨在研究PP-PTSD的患病率及相关预测因素,重点关注既往创伤后应激障碍(PTSD)的作用以及分娩后的时间。少数女性在成功分娩后出现了PP-PTSD。急性PP-PTSD的发生率在4.6%至6.3%之间,在高质量研究的社区样本中,高达16.8%的女性出现了具有临床意义的PP-PTSD症状。分娩的负面主观体验是最重要的预测因素。分娩前确诊为PTSD会导致PP-PTSD;然而,未患PTSD的女性也出现了PP-PTSD,急性发生率为4.6%,这表明在产后出现了新的PTSD。尽管大多数女性应对良好,但对一些女性来说,分娩可能被视为极具压力的经历,甚至会导致PP-PTSD症状的出现。需要更多研究来了解产后适应情况以及与分娩相关的创伤后应激结果。