Klapp Christine, Fisch Silvia, Keller Theresa, Stasun Ulrike, Nazmy Nurina, Hohmann Cynthia, Hinkson Larry, Henrich Wolfgang, Bergmann Karl E, Bergmann Renate L, Keil Thomas
1Department of Obstetrics, Charité - Universitätsmedizin Berlin, 10098 Berlin, Germany.
2Department of Neonatology, Charité - Universitätsmedizin Berlin, 10098 Berlin, Germany.
Matern Health Neonatol Perinatol. 2019 Aug 22;5:14. doi: 10.1186/s40748-019-0109-5. eCollection 2019.
Our aim was to examine the effects of an early perinatal prevention program offered to mothers and families suffering from significant psychosocial burden.
All mothers giving birth in a Berlin university hospital during Jan-Aug 2013 were screened with a standardized 27-item questionnaire by trained staff. Mothers with a screening-score ≥ 3, who were not enrolled in other public support programs, were defined as psychosocially burdened. They received a detailed needs assessment and were followed up with counseling. When necessary, affected mothers were voluntarily guided through to specialized 'early support' institutions during the 12-month-intervention period. The historical control group (care-as-usual) consisted of children born at the same hospital the year before.At 12 months postnatally, we interviewed mothers in both groups to assess their stress burden and coping skills by Parenting Stress Index and assessed the current childcare condition. Differences between the groups were compared by multivariable logistic regression analyses adjusting for potential confounders.
The intervention group and the control group included 225 and 157 families, respectively. After 12-months, mothers in the 'early support' intervention group had significantly less often depression (adjusted odds ratio 0.25, 95%-confidence interval 0.07-0.94), less often a disturbed relationship with the parenting partner (0.34, 0.10-1.14) and reported reduced stress due to the child's demands (0.40, 0.15-1.10) compared to the control group. Childcare indicators did not differ between the 2 groups.
In mothers at high psychosocial risk, the 'early support' intervention program seemed to reduce the occurrence of depression and several stress indicators in the first postnatal year.
我们的目的是研究一项早期围产期预防计划对遭受重大心理社会负担的母亲及其家庭的影响。
2013年1月至8月在柏林一家大学医院分娩的所有母亲均由经过培训的工作人员使用标准化的27项问卷进行筛查。筛查分数≥3且未参加其他公共支持计划的母亲被定义为有心理社会负担。她们接受了详细的需求评估，并接受了咨询随访。必要时，在12个月的干预期内，受影响的母亲会被自愿引导至专门的“早期支持”机构。历史对照组（常规护理）由前一年在同一家医院出生的儿童组成。产后12个月，我们对两组母亲进行了访谈，通过育儿压力指数评估她们的压力负担和应对技巧，并评估当前的育儿状况。通过多变量逻辑回归分析比较两组之间的差异，并对潜在的混杂因素进行调整。
干预组和对照组分别包括225个和157个家庭。12个月后，“早期支持”干预组的母亲患抑郁症的频率显著低于对照组（调整后的优势比为0.25，95%置信区间为0.07-0.94），与育儿伴侣关系失调的频率也显著低于对照组（0.34，0.10-1.14），并且报告因孩子的需求而产生的压力有所减轻（0.40，0.15-1.10）。两组之间的育儿指标没有差异。
对于心理社会风险较高的母亲，“早期支持”干预计划似乎降低了产后第一年抑郁症的发生率和一些压力指标。
