Ziama Arkin Infancy Institute, Interdisciplinary Center (IDC), Hanadiv Street 71, Herzliya, Israel; Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), HaUniversita 8, Herzliya, Israel.
Be'er Ya'akov Medical Center, Be'er Ya'akov, Israel; Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel.
Midwifery. 2021 Dec;103:103143. doi: 10.1016/j.midw.2021.103143. Epub 2021 Sep 14.
Growing literature has identified childbirth as a potentially traumatic event, following which mothers may develop symptoms of Post-Traumatic-Stress-Following-Childbirth. The current study is the first to prospectively examine a pathway of risk from mothers' prenatal trait-anxiety, to Acute-Stress-Immediately-Following-Childbirth, and later symptoms of Post-Traumatic-Stress-Following-Childbirth, in a low-risk community sample. Auxiliary analyses explored whether doula care during childbirth moderated risk.
149 pregnant women were randomly selected. Prenatal trait-anxiety was assessed toward the end of pregnancy, Acute-Stress-Immediately-Following-Childbirth at two-days post-partum, and symptoms of Post-Traumatic-Stress-Following-Childbirth at one-month post-partum.
Results indicated a significant indirect pathway from prenatal trait-anxiety to Post-Traumatic-Stress-Following-Childbirth, through Acute-Stress-Immediately-Following-Childbirth. Two groups were generated ad hoc for auxiliary analyses: participants who opted to receive doula care during childbirth (n=21; 14%) versus participants who received care as usual (n=128; 86%). Analyses provided preliminary support for doula care as a potential moderator of risk.
Results point toward prenatal trait-anxiety and Acute-Stress-Immediately-Following-Childbirth as significant risk factors for Post-Traumatic-Stress-Following-Childbirth. Findings inform preventive screening implicating the prenatal period as well as the postnatal hospital stay as important time windows for preventive screening. Finally, preliminary support for moderating effects of doula care suggest that preventive interventions administered during the perinatal period may effectively reduce anxiety-related risk for Post-Traumatic-Stress-Following-Childbirth.
越来越多的文献表明分娩是一种潜在的创伤性事件，之后母亲可能会出现产后创伤后应激症状。本研究首次前瞻性地研究了低风险社区样本中母亲产前特质焦虑、分娩后即刻急性应激以及随后产后创伤后应激症状的风险途径。辅助分析探讨了分娩时导乐护理是否会缓和风险。
随机选择 149 名孕妇。在妊娠末期评估产前特质焦虑，在产后两天评估分娩后即刻急性应激，在产后一个月评估产后创伤后应激症状。
结果表明，产前特质焦虑与产后创伤后应激之间存在显著的间接途径，通过分娩后即刻急性应激。为辅助分析专门生成了两组：选择分娩时接受导乐护理的参与者（n=21；14%）与接受常规护理的参与者（n=128；86%）。分析初步支持导乐护理作为风险的潜在调节因素。
结果表明产前特质焦虑和分娩后即刻急性应激是产后创伤后应激的重要危险因素。研究结果表明，产前筛查和产后住院期间是进行预防筛查的重要时间窗口。最后，对导乐护理的调节作用的初步支持表明，在围产期进行的预防干预可能会有效降低产后创伤后应激的焦虑相关风险。
