Horsch Antje, Vial Yvan, Favrod Céline, Harari Mathilde Morisod, Blackwell Simon E, Watson Peter, Iyadurai Lalitha, Bonsall Michael B, Holmes Emily A
Department Woman-Mother-Child, University Hospital Lausanne, Lausanne, Switzerland; Department of Endocrinology, Diabetes, and Metabolism, University Hospital Lausanne, Lausanne, Switzerland.
Department Woman-Mother-Child, University Hospital Lausanne, Lausanne, Switzerland.
Behav Res Ther. 2017 Jul;94:36-47. doi: 10.1016/j.brat.2017.03.018. Epub 2017 Apr 6.
Preventative psychological interventions to aid women after traumatic childbirth are needed. This proof-of-principle randomized controlled study evaluated whether the number of intrusive traumatic memories mothers experience after emergency caesarean section (ECS) could be reduced by a brief cognitive intervention. 56 women after ECS were randomized to one of two parallel groups in a 1:1 ratio: intervention (usual care plus cognitive task procedure) or control (usual care). The intervention group engaged in a visuospatial task (computer-game 'Tetris' via a handheld gaming device) for 15 min within six hours following their ECS. The primary outcome was the number of intrusive traumatic memories related to the ECS recorded in a diary for the week post-ECS. As predicted, compared with controls, the intervention group reported fewer intrusive traumatic memories (M = 4.77, SD = 10.71 vs. M = 9.22, SD = 10.69, d = 0.647 [95% CI: 0.106, 1.182]) over 1 week (intention-to-treat analyses, primary outcome). There was a trend towards reduced acute stress re-experiencing symptoms (d = 0.503 [95% CI: -0.032, 1.033]) after 1 week (intention-to-treat analyses). Times series analysis on daily intrusions data confirmed the predicted difference between groups. 72% of women rated the intervention "rather" to "extremely" acceptable. This represents a first step in the development of an early (and potentially universal) intervention to prevent postnatal posttraumatic stress symptoms that may benefit both mother and child.
ClinicalTrials.gov, www.clinicaltrials.gov, NCT02502513.
需要采取预防性心理干预措施来帮助经历过创伤性分娩的女性。这项原理验证性随机对照研究评估了通过简短的认知干预，能否减少母亲在紧急剖宫产（ECS）后经历的侵入性创伤记忆的数量。56名ECS术后的女性按1:1比例随机分为两个平行组：干预组（常规护理加认知任务程序）或对照组（常规护理）。干预组在ECS术后6小时内通过手持游戏设备进行15分钟的视觉空间任务（电脑游戏“俄罗斯方块”）。主要结局是ECS术后一周内日记中记录的与ECS相关的侵入性创伤记忆的数量。正如预期的那样，与对照组相比，干预组在1周内报告的侵入性创伤记忆较少（意向性分析，主要结局：M = 4.77，SD = 10.71 vs. M = 9.22，SD = 10.69，d = 0.647 [95% CI：0.106，1.182]）。1周后有急性应激再体验症状减轻的趋势（意向性分析，d = 0.503 [95% CI：-0.032，1.033]）。对每日侵入数据的时间序列分析证实了组间的预期差异。72%的女性对干预的评价为“相当”到“极其”可接受。这代表了开发一种早期（可能具有普遍性）干预措施以预防产后创伤后应激症状的第一步，这可能对母亲和孩子都有益。
ClinicalTrials.gov，www.clinicaltrials.gov，NCT02502513。
