Schobinger Elisabeth, Stuijfzand Suzannah, Horsch Antje
Institute of higher Education and Research in Healthcare in French, University of Lausanne, Lausanne, Switzerland.
Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
Front Psychiatry. 2020 Dec 22;11:562054. doi: 10.3389/fpsyt.2020.562054. eCollection 2020.
Up to 30% of women view their childbirth as traumatic. This experience can lead to acute stress disorder or post-traumatic stress disorder. The negative impact of maternal post-traumatic stress disorder following childbirth reaches beyond the mother, potentially affecting her child's development and the couple's relationship. Research on post-traumatic stress disorder following childbirth is scarce. Acute stress disorder is suggested to be an important predictor of post-traumatic stress disorder in mothers, but little is known about acute stress disorder following childbirth. Furthermore, there is limited information about the comparison or relation of acute stress disorder and post-traumatic stress disorder following childbirth between parents. [1] To compare the prevalence rates and severity of acute stress disorder and post-traumatic stress disorder symptoms between parents following childbirth by taking anxiety and depression symptoms, as well as obstetric variables and previous traumatic events into account and [2] To determine if acute stress disorder is a predictor of post-traumatic stress disorder. A prospective population-based design was used. = 647 participants were recruited from future parents who attended appointments at the Obstetrics and Gynecology unit at a Swiss university hospital. Self-report questionnaires were used: Post-traumatic Diagnostic Scale in the third trimester of pregnancy (T1) and 1 month post-partum (T3), Acute Stress Disorder Scale at 1 week post-partum (T2), and Hospital Anxiety and Depression Scale at all time points. Obstetric and neonatal variables were retrieved from hospital records. At T2, 63.9% of mothers and 51.7% of fathers presented symptoms of acute stress disorder. At T3, 20.7% of mothers and 7.2% of fathers had symptoms of post-traumatic stress disorder. Acute stress disorder was a predictor of post-partum post-traumatic stress disorder (Odds ratio: 8.6, IC 95% [1.85; 40.42]). Depression symptoms was a significant confounder in the prediction of post-traumatic stress disorder following childbirth, but not anxiety or previous perinatal loss. Little is known about parental differences in acute stress disorder and post-traumatic stress disorder symptoms following childbirth. Results indicate that parents may suffer from acute stress disorder and post-traumatic stress disorder symptoms after childbirth and that acute stress disorder is a predictor of post-traumatic stress disorder after childbirth for both parents. Sensitization of maternity staff to these results may assist in earlier identification of and appropriate treatment for at-risk parents.
高达30%的女性认为自己的分娩经历具有创伤性。这种经历可能导致急性应激障碍或创伤后应激障碍。产后母亲创伤后应激障碍的负面影响不仅限于母亲自身，还可能影响其孩子的发育以及夫妻关系。关于产后创伤后应激障碍的研究较少。急性应激障碍被认为是母亲创伤后应激障碍的重要预测指标，但人们对产后急性应激障碍了解甚少。此外，关于产后父母之间急性应激障碍与创伤后应激障碍的比较或关系的信息有限。[1]通过考虑焦虑和抑郁症状、产科变量及既往创伤事件，比较产后父母急性应激障碍和创伤后应激障碍症状的患病率及严重程度；[2]确定急性应激障碍是否为创伤后应激障碍的预测指标。采用基于人群的前瞻性设计。从瑞士一家大学医院妇产科就诊的准父母中招募了647名参与者。使用了自我报告问卷：妊娠晚期（T1）和产后1个月（T3）的创伤后诊断量表、产后1周（T2）的急性应激障碍量表以及所有时间点的医院焦虑抑郁量表。产科和新生儿变量从医院记录中获取。在T2时，63.9%的母亲和51.7%的父亲出现急性应激障碍症状。在T3时，20.7%的母亲和7.2%的父亲有创伤后应激障碍症状。急性应激障碍是产后创伤后应激障碍的预测指标（比值比：8.6，95%置信区间[1.85；40.42]）。抑郁症状是产后创伤后应激障碍预测中的显著混杂因素，但焦虑或既往围产期损失不是。人们对产后父母在急性应激障碍和创伤后应激障碍症状方面的差异了解甚少。结果表明，父母在产后可能会出现急性应激障碍和创伤后应激障碍症状，且急性应激障碍是父母产后创伤后应激障碍的预测指标。产科工作人员对这些结果的认识提高可能有助于更早地识别高危父母并给予适当治疗。
