Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA.
School of Psychology, Interdisciplinary Center (IDC) Herzliya, Israel.
J Affect Disord. 2021 Mar 1;282:122-125. doi: 10.1016/j.jad.2020.12.101. Epub 2020 Dec 28.
Knowledge of women's experience of childbirth in the outbreak of the coronavirus (COVID-19) pandemic and associated maternal health outcomes is scarce.
A sample of primarily American women who gave birth around the height of COVID-19 (n = 1,611) and matched controls, i.e., women who gave birth before COVID-19 (n = 640), completed an anonymous Internet survey about recent childbirth, birth-related traumatic stress (peritraumatic distress inventory; PTSD-checklist), maternal bonding (maternal attachment inventory; mother-to-infant bonding scale) and breastfeeding status. Groups (n = 637 in each) were matched on demographics, prior mental health/trauma and childbirth factors to determine the unique contribution of COVID-19 to the psychological experience of childbirth.
Mothers in COVID-19-exposed communities endorsed more clinically acute stress response to childbirth than matched controls (Z = 2.65, p = .008, OR= 1.38). A path mediation model revealed that acute stress mediated the relationship between study group and postpartum outcomes. Specifically, higher acute stress response in birth was associated with more childbirth-related posttraumatic stress disorder symptoms (β = .42, p < .001) and less bonding with the infant (β = .26, p < .001), including breastfeeding problems (β = .10, p < .01).
Use of a convenient internet sample introduces bias towards more educated women and reliance on retrospective self-report assessments may entail recall bias.
COVID-19 is a major stressor for delivering women. It can heighten traumatic childbirth experiences and interfere with successful postpartum adjustment. Clinical attention to traumatic stress in childbirth and problems with caring for the young during this pandemic is important.
关于女性在冠状病毒（COVID-19）大流行期间分娩的经历以及相关的产妇健康结局的知识很少。
一项主要由美国女性组成的样本在 COVID-19 高峰期（n=1611）和匹配的对照组（即 COVID-19 之前分娩的女性，n=640）完成了一项关于近期分娩、与分娩相关的创伤后应激（创伤后应激障碍检查表；创伤后应激障碍检查表）、母婴联系（母婴联系清单；母婴联系量表）和母乳喂养状况的匿名互联网调查。在人口统计学、先前的心理健康/创伤和分娩因素方面，将两组（每组 637 人）进行匹配，以确定 COVID-19 对分娩心理体验的独特贡献。
暴露于 COVID-19 的社区中的母亲比匹配的对照组更认可分娩后的急性应激反应（Z=2.65，p=0.008，OR=1.38）。路径中介模型显示，急性应激在出生时与产后结果之间存在中介关系。具体而言，较高的急性应激反应与更多的分娩后创伤后应激障碍症状相关（β=0.42，p<.001），与婴儿的联系较少（β=0.26，p<.001），包括母乳喂养问题（β=0.10，p<.01）。
使用方便的互联网样本会导致偏向于受教育程度更高的女性，并且依赖于回顾性自我报告评估可能会涉及到回忆偏差。
COVID-19 是分娩女性的主要压力源。它可以加剧创伤性分娩经历，并干扰产后的成功调整。在这场大流行期间，关注分娩时的创伤后应激和照顾幼儿的问题非常重要。
