Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
Arch Gynecol Obstet. 2022 Sep;306(3):687-697. doi: 10.1007/s00404-021-06310-5. Epub 2021 Nov 1.
This study examined the rates of unexpected birth experiences due to the COVID-19 pandemic and its association with women's postpartum mental health symptoms (depression, generalized anxiety, and PTSD).
Our cross-sectional analysis included postpartum women (N = 506) who reported on birth plan changes attributed to the COVID-19 pandemic through the PEACE (Perinatal Experiences and COVID-19 Effects) Study, an online survey that took place between May 2020 and May 2021. Covariates included sociodemographic variables, number of days since the pandemic, pre-pregnancy mental health history, and protective factors such as social support, distress tolerance, and resilience.
Prevalent COVID-19 pandemic changes in the birth experience included not having support people (e.g., partners and friends) permitted to participate in the baby's delivery (33.5%), reduced access to preferred medications before or after delivery (9.7%), unavailable health care providers for the baby's birth as planned (9.6%), and other changes (13.8%). The reduced access to medications was associated with those reporting higher levels of depressive (β = .10, p < .01) and PTSD symptoms (β = .07, p < .05). Separation from their baby for a long period after delivery (β = .10, p < .05) and other changes (β = .10, p < .01) were associated with higher levels of PTSD symptoms.
Unexpected changes to the birth experience due to the COVID-19 pandemic may have small but persistent effects on depressive and PTSD symptoms. Given increased vigilance and its association with subsequent PTSD, acknowledging any fear of viral contagion within the hospital setting but informing women the plans for ensuring safety may be preventive for later mental health symptomatology.
本研究考察了由于 COVID-19 大流行导致的意外分娩经历的发生率及其与女性产后心理健康症状（抑郁、广泛性焦虑和 PTSD）的关系。
我们的横断面分析包括通过 PEACE（围产期经历和 COVID-19 影响）研究报告 COVID-19 大流行导致的分娩计划改变的产后妇女（N=506），这是一项在线调查，于 2020 年 5 月至 2021 年 5 月期间进行。协变量包括社会人口统计学变量、大流行后天数、孕前心理健康史以及社会支持、压力耐受和恢复力等保护因素。
分娩经历中普遍存在 COVID-19 大流行的变化，包括不允许支持人员（如伴侣和朋友）参与分娩（33.5%）、分娩前后减少获得首选药物的机会（9.7%）、无法按计划为婴儿分娩提供医疗服务人员（9.6%）和其他变化（13.8%）。减少药物获取与报告更高水平抑郁症状（β=0.10，p<0.01）和 PTSD 症状（β=0.07，p<0.05）有关。分娩后与婴儿长时间分离（β=0.10，p<0.05）和其他变化（β=0.10，p<0.01）与 PTSD 症状水平较高有关。
由于 COVID-19 大流行导致的分娩经历的意外变化可能对抑郁和 PTSD 症状产生微小但持续的影响。鉴于对医院环境中病毒感染的警惕性增加及其与随后的 PTSD 相关，承认医院环境中任何对病毒感染的恐惧，但告知女性确保安全的计划可能对以后的心理健康症状具有预防作用。
