Department of Obstetrics and Gynecology, OLVG Hospital, Amsterdam, Netherlands.
VU University Medical Center, Amsterdam, Netherlands.
Acta Obstet Gynecol Scand. 2018 Jun;97(6):648-656. doi: 10.1111/aogs.13291. Epub 2018 Mar 2.
Between 9 and 44% of women experience giving birth as traumatic, and 3% of women develop a post-traumatic stress disorder following childbirth. Knowledge on risk factors is abundant, but studies on treatment are limited. This study aimed to present an overview of means to prevent traumatic birth experiences and childbirth-related post-traumatic stress disorder.
Major databases [Cochrane; Embase; PsycINFO; PubMed (Medline)] were searched using combinations of the key words and their synonyms.
After screening titles and abstracts and reading 135 full-text articles, 13 studies were included. All evaluated secondary prevention, and none primary prevention. Interventions included debriefing, structured psychological interventions, expressive writing interventions, encouraging skin-to-skin contact with healthy newborns immediately postpartum and holding or seeing the newborn after stillbirth. The large heterogeneity of study characteristics precluded pooling of data. The writing interventions to express feelings appeared to be effective in prevention. A psychological intervention including elements of exposure and psycho-education seemed to lead to fewer post-traumatic stress disorder symptoms in women who delivered via emergency cesarean section.
No research has been done on primary prevention of traumatic childbirth. Research on secondary prevention of traumatic childbirth and post-traumatic stress disorder following delivery provides insufficient evidence that the described interventions are effective in unselected groups of women. In certain subgroups, results are inhomogeneous.
9%至 44%的女性经历分娩时会感到创伤，3%的女性在分娩后会发展为创伤后应激障碍。关于风险因素的知识很丰富，但关于治疗的研究有限。本研究旨在概述预防创伤性分娩经历和与分娩相关的创伤后应激障碍的方法。
主要数据库[Cochrane; Embase; PsycINFO; PubMed (Medline)]使用关键词及其同义词的组合进行搜索。
在筛选标题和摘要并阅读了 135 篇全文文章后，纳入了 13 项研究。所有研究均评估了二级预防，而无一进行一级预防。干预措施包括汇报、结构化心理干预、表达性写作干预、鼓励产后立即与健康新生儿进行皮肤接触并抱着或看到新生儿，以及死胎后。研究特征的高度异质性使得数据无法进行汇总。表达感受的写作干预似乎在预防方面有效。包括暴露和心理教育元素的心理干预似乎可减少行急诊剖宫产分娩的女性的创伤后应激障碍症状。
没有关于预防创伤性分娩的一级预防的研究。关于创伤性分娩和分娩后创伤后应激障碍的二级预防研究提供的证据不足，无法证明所描述的干预措施在未选择的女性群体中有效。在某些亚组中，结果不一致。
