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产妇产后抑郁症:NICU 内外的危险因素、影响及干预措施。

Maternal postpartum depression: risk factors, impacts, and interventions for the NICU and beyond.

机构信息

University of Pennsylvania, School of Social Policy and Practice.

Drexel University, Dornsife School of Public Health.

出版信息

Curr Opin Pediatr. 2021 Jun 1;33(3):331-341. doi: 10.1097/MOP.0000000000001011.

Abstract

PURPOSE OF REVIEW

Postpartum depression (PPD) negatively impacts caregivers, infants, siblings, and entire families. Mothers with infants admitted to the neonatal intensive care unit (NICU) face additional risk for PPD, coupled with risk factors extending beyond a NICU admision. The novelty of this review is the focus on maternal PPD for mothers with infants admitted to the NICU. Interventions aimed at limiting and preventing PPD in this population include: prenatal and postpartum depression screening, PPD symptom awareness and monitoring, and trauma-informed care.

RECENT FINDINGS

PPD, the most frequent complication of childbirth, affects approximately 10-15% of mothers worldwide. Prevalence rates increase to 40% for mothers whose infant is admitted to the NICU. PPD can affect maternal and child health across the life course and predispose future generations to a myriad of developmental, psychosocial, and physical challenges. Prevalence rates are higher for racial and ethnic minorities, immigrant and refugee populations, and mothers in rural locations. Trauma-informed care is suggested at individual and organizational levels, leading to better care for those with and without previous trauma exposure.

SUMMARY

Increasing PPD symptom awareness, screening for PPD, and connections with resources should begin during prenatal visits. Care teams should discuss barriers to resources for mothers, children, and families to improve access and support.

摘要

目的综述

产后抑郁症(PPD)会对照顾者、婴儿、兄弟姐妹和整个家庭产生负面影响。有新生儿入住重症监护病房(NICU)的婴儿的母亲面临着更高的 PPD 风险,并且还存在超出 NICU 入院的风险因素。本次综述的新颖之处在于关注有新生儿入住 NICU 的母亲的产后抑郁症。旨在限制和预防该人群 PPD 的干预措施包括:产前和产后抑郁症筛查、PPD 症状意识和监测,以及创伤知情护理。

最近的发现

PPD 是分娩最常见的并发症之一,全球约有 10-15%的母亲受到影响。如果婴儿入住 NICU,母亲的患病率则上升至 40%。PPD 会影响母婴健康,贯穿整个生命周期,并使后代面临多种发育、心理社会和身体挑战。少数民族、移民和难民以及农村地区的母亲患病率更高。建议在个人和组织层面实施创伤知情护理,为有和没有创伤暴露史的人提供更好的护理。

总结

应在产前就诊期间开始提高对 PPD 症状的认识、进行 PPD 筛查,并与资源建立联系。护理团队应讨论母亲、儿童和家庭获取资源的障碍,以改善获取和支持。

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