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早产至出生后18个月产妇创伤的患病率及预测因素:一项纵向观察性描述性研究。

Prevalences and predictive factors of maternal trauma through 18 months after premature birth: A longitudinal, observational and descriptive study.

作者信息

Brunson Emilie, Thierry Aurore, Ligier Fabienne, Vulliez-Coady Laurianne, Novo Alexandre, Rolland Anne-Catherine, Eutrope Julien

机构信息

Université de Formation et de Recherche de médecine, Université de Reims Champagne-Ardenne, Reims, France.

Unité d'Aide Méthodologique, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Reims, France.

出版信息

PLoS One. 2021 Feb 24;16(2):e0246758. doi: 10.1371/journal.pone.0246758. eCollection 2021.

Abstract

Posttraumatic reactions are common among mothers of preterm infants and can have a negative influence on their quality of life and lead to interactional difficulties with their baby. Given the possible trajectories of posttraumatic reactions, we hypothesized that prevalences of postpartum posttraumatic reactions at given times underestimate the real amount of mothers experiencing these symptoms within 18 months following delivery. Additionally, we examined whether sociodemographic and clinical characteristics of dyads influence the expression of posttraumatic symptoms among these mothers. A sample of 100 dyads was included in this longitudinal study led by 3 french university hospitals. Preterm infants born before 32 weeks of gestation and their mothers were followed-up over 18 months and attended 5 visits assessing the infants' health conditions and the mothers' psychological state with validated scales. Fifty dyads were retained through the 18 months of the study. The period prevalence of posttraumatic reactions was calculated and a group comparison was conducted to determine their predictive factors. Thirty-six percent of the mothers currently suffered from posttraumatic symptoms 18 months after their preterm delivery. The 18 months period prevalence was 60.4% among all the mothers who participated until the end of the follow-up. There was a statistical link between posttraumatic symptoms and a shorter gestational age at delivery, C-section, and the mother's psychological state of mind at every assessment time. Only a small proportion of mothers were receiving psychological support at 18 months. Preterm mothers are a population at risk of developing a long-lasting postpartum posttraumatic disorder, therefore immediate and delayed systematic screenings for posttraumatic symptoms are strongly recommended to guide at-risk mothers towards appropriate psychological support.

摘要

创伤后反应在早产婴儿的母亲中很常见,可能会对她们的生活质量产生负面影响,并导致与婴儿互动困难。考虑到创伤后反应的可能发展轨迹,我们推测特定时间点的产后创伤后反应患病率低估了分娩后18个月内出现这些症状的母亲的实际数量。此外,我们研究了母婴的社会人口学和临床特征是否会影响这些母亲创伤后症状的表现。这项纵向研究纳入了由3家法国大学医院牵头的100对母婴样本。对妊娠32周前出生的早产婴儿及其母亲进行了18个月的随访,并通过经过验证的量表进行了5次访视,评估婴儿的健康状况和母亲的心理状态。在18个月的研究期间,保留了50对母婴样本。计算了创伤后反应的期间患病率,并进行了组间比较以确定其预测因素。36%的母亲在早产18个月后目前患有创伤后症状。在参与随访直至结束的所有母亲中,18个月的期间患病率为60.4%。创伤后症状与分娩时较短的孕周、剖宫产以及每次评估时母亲的心理状态之间存在统计学关联。在18个月时,只有一小部分母亲接受了心理支持。早产母亲是有患长期产后创伤后障碍风险的人群,因此强烈建议立即和延迟进行系统性的创伤后症状筛查,以引导有风险的母亲获得适当的心理支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c79/7904178/62a54855c13b/pone.0246758.g001.jpg

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