The Oxford Institute of Clinical Psychology Training, Isis Education Centre, Warneford Hospital, Oxford OX3 7JX, United Kingdom.
Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, United Kingdom.
J Affect Disord. 2018 Jan 1;225:18-31. doi: 10.1016/j.jad.2017.07.045. Epub 2017 Jul 27.
Approximately 3.3% of women in pregnancy have posttraumatic stress disorder (PTSD) and 4% of women postpartum PTSD. The impact of maternal PTSD during the perinatal period (from conception until one year postpartum) on child outcomes has not been systematically examined.
A systematic review was conducted to synthesize and critically evaluate quantitative research investigating the association between perinatal PTSD and child outcomes. Databases EMBASE, BNI, Medline, PsycInfo and CINAHL were searched using specific inclusion and exclusion criteria.
26 papers reporting 21 studies were identified that examined associations between perinatal PTSD and postpartum birth outcomes, child development, and mother-infant relationship. Studies reviewed were heterogeneous, with poor-to-medium scores of methodological quality. Results showed that maternal postpartum PTSD is associated with low birth weight and lower rates of breastfeeding. Evidence for an association between maternal PTSD and preterm birth, fetal growth, head circumference, mother-infant interaction, the mother-infant relationship or child development is contradictory. Associations between maternal PTSD and infant salivary cortisol levels, and eating/sleeping difficulties are based on single studies, so require replication.
Methodological weaknesses of the studies included insufficient sample size, use of invalidated measures, and limited external validity.
Findings suggest that perinatal PTSD is linked with some negative child outcomes. Early screening for PTSD during the perinatal period may be advisable and onward referral for effective treatment, if appropriate. Future research using larger sample sizes, validated and reliable clinical interviews to assess PTSD, and validated measures to assess a range of child outcomes, is needed.
约 3.3%的孕妇患有创伤后应激障碍（PTSD），4%的产妇患有产后 PTSD。围产期（从受孕到产后一年）期间母亲 PTSD 对儿童结局的影响尚未得到系统研究。
进行了系统评价，以综合和批判性评估定量研究，调查围产期 PTSD 与儿童结局之间的关系。使用特定的纳入和排除标准，在 EMBASE、BNI、Medline、PsycInfo 和 CINAHL 数据库中进行搜索。
确定了 26 篇报告了 21 项研究的论文，这些研究调查了围产期 PTSD 与产后出生结局、儿童发育和母婴关系之间的关系。综述的研究具有异质性，方法学质量评分较差至中等。结果表明，产妇产后 PTSD 与低出生体重和较低的母乳喂养率有关。母亲 PTSD 与早产、胎儿生长、头围、母婴互动、母婴关系或儿童发育之间的关联证据相互矛盾。母亲 PTSD 与婴儿唾液皮质醇水平以及饮食/睡眠困难之间的关联基于单个研究，因此需要复制。
研究的方法学弱点包括样本量不足、使用无效的测量方法以及有限的外部有效性。
研究结果表明，围产期 PTSD 与一些负面的儿童结局有关。在围产期期间早期筛查 PTSD 可能是明智的，如果需要，进行有效的治疗。需要使用更大的样本量、经过验证和可靠的临床访谈来评估 PTSD 以及经过验证的措施来评估一系列儿童结局的未来研究。
