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预测低风险女性产后创伤后应激和抑郁症状的远因和近因:使用结构方程模型的生物心理社会前瞻性研究。

Predicting postpartum post-traumatic stress and depressive symptoms in low-risk women from distal and proximal factors: a biopsychosocial prospective study using structural equation modeling.

机构信息

Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, Madrid, 28922, Alcorcón, Spain.

Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón, Spain.

出版信息

Arch Gynecol Obstet. 2021 Jun;303(6):1415-1423. doi: 10.1007/s00404-020-05857-z. Epub 2020 Nov 7.

Abstract

PURPOSE

Posttraumatic stress (PTSD) and depression (PPD) are common mental disorders in the postpartum that constitute a threat both to the mother and the baby. It is unclear whether both disorders share similar antecedents, which is important to plan efficient interventions. The goal of this study was to examine the contribution of set of biopsychosocial predictors on both PTSD and PPD.

METHODS

The study design was prospective. The study was conducted at Hospital Universitario de Fuenlabrada, a public university hospital located in the south of Madrid (Spain). The sample was composed of 116 pregnant women with low pregnancy risk. STROBE reporting guidelines were followed.

RESULTS

The multivariate results show that psychopathology severity assessed during the first trimester (ß = 0.50, p < .001) and the Apgar score 5 min after delivery (ß = - 0.19, p = .030) were the two variables to significantly contribute to postpartum depressive symptoms. Conversely, only satisfaction with home care after delivery was independently associated with postpartum posttraumatic stress (ß = - 0.26, p = .016). The proposed model explained 21.8% of the variance of postpartum depressive symptoms (p = .041) and 27.1% of the variance of posttraumatic stress symptoms (p = .014).

CONCLUSION

Special attention should be given to shared and unique predictive factors of PDD and PTSD to develop effective prevention programs in perinatal care.

摘要

目的

创伤后应激障碍(PTSD)和产后抑郁(PPD)是产后常见的精神障碍,对母亲和婴儿都构成威胁。目前尚不清楚这两种疾病是否具有相似的发病因素,而这对于制定有效的干预措施非常重要。本研究旨在探讨一系列生物心理社会预测因素对 PTSD 和 PPD 的影响。

方法

研究设计为前瞻性。该研究在马德里南部的一所公立大学附属医院——Fuenlabrada 大学医院进行。样本由 116 名低妊娠风险的孕妇组成。本研究遵循 STROBE 报告指南。

结果

多元回归结果表明,妊娠早期评估的精神病理学严重程度(β=0.50,p<0.001)和分娩后 5 分钟的阿普加评分(β=-0.19,p=0.030)是两个与产后抑郁症状显著相关的变量。相反,只有对产后家庭护理的满意度与产后创伤后应激有关(β=-0.26,p=0.016)。所提出的模型解释了产后抑郁症状的 21.8%(p=0.041)和创伤后应激症状的 27.1%(p=0.014)的方差。

结论

在围产期护理中,应特别关注 PDD 和 PTSD 的共同和独特的预测因素,以制定有效的预防计划。

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