University of North Carolina School of Medicine , Chapel Hill , NC , USA.
Department of Obstetrics & Gynecology , Chapel Hill , NC , USA.
J Psychosom Obstet Gynaecol. 2019 Dec;40(4):304-310. doi: 10.1080/0167482X.2018.1512095. Epub 2018 Sep 11.
To evaluate the feasibility and acceptability of a protocol determining the relationship between emergency team response (ETR) during childbirth and acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) symptoms. In a prospective, observational, cohort design, women experiencing ETR during childbirth were approached and recruited on postpartum day-1 and followed for six weeks. Demographics, obstetric and birth characteristics, ASD scores and PTSD scores (by Impact of Events Scale, IES and PCL-civilian) were recorded. Recruitment and retention rates were recorded, and scores were compared to women who did not experience ETR. Three hundred sixty-nine were approached and 249 were enrolled (67.5% recruitment rate). One hundred twenty-five completed all procedures (50.2% retention). Twenty experienced ETR (3.5% event rate), 12 enrolled (60.0% recruitment rate) and 8 completed the study (66.7% retention). The ETR group had higher PCL and IES scores (PCL: ETR median 12, non-ETR median 2, = .08; IES: ETR median 22.5, non-ETR median 20, = .08). ASD scores were similar between groups. Methodology investigating the link between ETR and postpartum psychological distress is feasible and acceptable. A relationship between ETR and PTSD symptoms appears to exist, with ETR being associated with higher PTSD scores compared to non-ETR childbirths. Methods that incorporate awareness of the unique concerns of vulnerable populations are needed.
评估确定分娩期间应急小组反应 (ETR) 与急性应激障碍 (ASD) 和创伤后应激障碍 (PTSD) 症状之间关系的方案的可行性和可接受性。在一项前瞻性、观察性、队列设计中,在产后第 1 天接触和招募经历分娩期间 ETR 的女性,并在六周内进行随访。记录人口统计学、产科和分娩特征、ASD 评分和 PTSD 评分(通过事件影响量表,IES 和 PCL-平民)。记录招募和保留率,并将评分与未经历 ETR 的女性进行比较。共接触了 369 名女性,招募了 249 名女性(招募率为 67.5%)。125 名女性完成了所有程序(保留率为 50.2%)。20 名女性经历了 ETR(发生率为 3.5%),12 名女性入组(招募率为 60.0%),8 名女性完成了研究(保留率为 66.7%)。ETR 组的 PCL 和 IES 评分较高(PCL:ETR 中位数 12,非 ETR 中位数 2,=0.08;IES:ETR 中位数 22.5,非 ETR 中位数 20,=0.08)。两组的 ASD 评分相似。调查 ETR 与产后心理困扰之间联系的方法是可行且可接受的。ETR 与 PTSD 症状之间似乎存在关联,与非 ETR 分娩相比,ETR 与更高的 PTSD 评分相关。需要采用能够认识到弱势群体特殊问题的方法。