一项关于催产素在低体重儿低收入女性中的初步研究：催产素与创伤后应激有关吗？
A Pilot Study of Oxytocin in Low-Income Women With a Low Birth-Weight Infant: Is Oxytocin Related to Posttraumatic Stress?
作者信息
Garfield Lindsey, Holditch-Davis Diane, Carter C Sue, McFarlin Barbara L, Seng Julia S, Giurgescu Carmen, White-Traut Rosemary
机构信息
Marcella Niehoff School of Nursing, Loyola University Chicago, Illinois (Dr Garfield); Duke School of Nursing, Durham, North Carolina (Dr Holditch-Davis); Indiana University, Bloomington (Dr Carter); University of Illinois, Chicago (Dr McFarlin); Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor (Dr Seng); The Ohio State University, Columbus (Dr Giurgescu); University of Illinois at Chicago, and Children's Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (Dr White-Traut).
出版信息
Adv Neonatal Care. 2019 Aug;19(4):E12-E21. doi: 10.1097/ANC.0000000000000601.
BACKGROUND
Negative outcomes related to prematurity may lead to maternal distress. Mothers of premature/low birth-weight infants report increased posttraumatic stress (50%) and depressive symptoms (63%) compared with mothers of full-term infants. Low-income, minority mothers with greater posttraumatic stress and depression have an increased risk for premature/low birth-weight delivery compared with their white counterparts. Variations in the neuropeptide oxytocin are implicated in lactation, perinatal depression, and maternal behavior.
PURPOSE
To examine the associations among posttraumatic stress, depressive symptoms, and oxytocin in a pilot sample of minority mothers with premature/low birth-weight infants in the neonatal intensive care unit (NICU).
METHODS
This study employed a descriptive, correlational pilot design of 8 minority, low-income mothers with premature/low birth-weight infants. Participants answered questionnaires pertaining to posttraumatic stress, depression, lactation, and demographics and oxytocin was measured. This is a substudy that added oxytocin values.
RESULTS
Four participants had elevated depressive symptoms and 5 supplied their own milk. Women who provided their own milk had lower depressive (t = 3.03, P = .023) and posttraumatic stress (t = 3.39, P = .015) symptoms compared with women not supplying their own milk. Women with elevated posttraumatic stress had higher levels of depressive symptoms (r(8) = 0.8, P = .006) and lower levels of oxytocin (r(8) = 0.77, P = .026).
IMPLICATIONS FOR PRACTICE
These results are congruent with previous literature on providing human milk and maternal mental health. In addition, we found a possible relationship between postpartum posttraumatic stress and oxytocin in minority women with premature/low birth-weight infants. NICU nurses should encourage lactation and assess mothers for posttraumatic stress and depressive symptoms.
IMPLICATIONS FOR RESEARCH
Research is needed to identify the biologic milieu associated with posttraumatic stress and depression in at-risk mothers.
背景
与早产相关的不良后果可能导致母亲情绪困扰。与足月儿母亲相比，早产/低体重儿的母亲报告有更高的创伤后应激障碍（50%）和抑郁症状（63%）。与白人母亲相比，低收入、少数族裔且有更高创伤后应激障碍和抑郁症状的母亲早产/低体重分娩的风险更高。神经肽催产素的变化与泌乳、围产期抑郁和母亲行为有关。
目的
在新生儿重症监护病房（NICU）中，对有早产/低体重儿的少数族裔母亲的一个试点样本，研究创伤后应激障碍、抑郁症状和催产素之间的关联。
方法
本研究采用描述性、相关性试点设计，纳入8名有早产/低体重儿的少数族裔、低收入母亲。参与者回答了有关创伤后应激障碍、抑郁、泌乳和人口统计学的问卷，并测量了催产素水平。这是一项增加了催产素值的子研究。
结果
4名参与者有抑郁症状加重，5名提供了自己的母乳。与未提供母乳的女性相比，提供母乳的女性抑郁症状（t = 3.03，P = .023）和创伤后应激障碍症状（t = 3.39，P = .015）更低。创伤后应激障碍加重的女性抑郁症状水平更高（r(8) = 0.8，P = .006），催产素水平更低（r(8) = 0.77，P = .026）。
对实践的启示
这些结果与先前关于提供母乳和母亲心理健康的文献一致。此外，我们发现有早产/低体重儿的少数族裔女性产后创伤后应激障碍与催产素之间可能存在关联。NICU护士应鼓励泌乳，并评估母亲是否有创伤后应激障碍和抑郁症状。
对研究的启示
需要开展研究来确定与高危母亲创伤后应激障碍和抑郁相关的生物环境。
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