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创伤暴露和创伤后应激障碍在秘鲁孕妇队列中的研究。

Trauma exposure and post-traumatic stress disorder in a cohort of pregnant Peruvian women.

机构信息

The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA.

Harvard Medical School, Boston, MA, 02115, USA.

出版信息

Arch Womens Ment Health. 2018 Apr;21(2):193-202. doi: 10.1007/s00737-017-0776-z. Epub 2017 Sep 13.

Abstract

Women have a higher prevalence of post-traumatic stress disorder (PTSD) than men, with a peak during the reproductive years. PTSD during pregnancy adversely impacts maternal and infant health outcomes. The objectives of this study were to estimate the prevalence of antepartum PTSD symptoms in a population of pregnant Peruvian women and to examine the impact of number of traumatic events and type of trauma experienced. The Traumatic Events Questionnaire was used to collect data about traumatic exposures. The Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C) was used to assess PTSD. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). Three thousand three hundred seventy-two pregnant women were interviewed. Of the 2920 who reported experiencing one or more traumatic events, 41.8% met criteria for PTSD (PCL-C score ≥ 26). A quarter of participants had experienced four or more traumas, and 60.5% of those women had PTSD. Interpersonal trauma was most strongly associated with PTSD (aOR, 3.20; 95% CI, 2.74-3.74), followed by unspeakable trauma (aOR, 2.87; 95% CI, 2.35-3.50), and structural trauma (aOR, 1.39; 95% CI, 1.15-1.67). These findings indicate the high prevalence of PTSD during pregnancy in the Peruvian population, which is relevant to other countries suffering from terrorism, war, or high rates of violence. This underscores the importance of screening for PTSD in pregnancy.

摘要

女性患创伤后应激障碍(PTSD)的比例高于男性,在生育期达到高峰。怀孕期间的 PTSD 会对母婴健康产生不利影响。本研究的目的是估计秘鲁孕妇人群中产前 PTSD 症状的患病率,并研究创伤事件数量和经历的创伤类型的影响。使用创伤事件问卷收集有关创伤暴露的数据。使用创伤后应激障碍检查表-平民版(PCL-C)评估 PTSD。使用多变量逻辑回归程序估计调整后的优势比(aOR)和 95%置信区间(95%CI)。对 3372 名孕妇进行了访谈。在报告经历过一次或多次创伤事件的 2920 名孕妇中,有 41.8%符合 PTSD 标准(PCL-C 得分≥26)。四分之一的参与者经历了四次或更多的创伤,其中 60.5%的女性患有 PTSD。人际创伤与 PTSD 相关性最强(aOR,3.20;95%CI,2.74-3.74),其次是难以言说的创伤(aOR,2.87;95%CI,2.35-3.50)和结构性创伤(aOR,1.39;95%CI,1.15-1.67)。这些发现表明,秘鲁人群中怀孕期间 PTSD 的患病率很高,这与遭受恐怖主义、战争或高暴力率的其他国家有关。这强调了在怀孕期间筛查 PTSD 的重要性。

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