Chakroun M, Aribi L, Ellouz S, Aloulou J
Service de psychiatrie B CHU Hèdi Chaker, 3000 Sfax, Tunisie; Faculté de médecine de Tunis, 1007 Tunis, Tunisie.
Service de psychiatrie B CHU Hèdi Chaker, 3000 Sfax, Tunisie.
Encephale. 2022 Dec;48(6):638-646. doi: 10.1016/j.encep.2021.06.020. Epub 2021 Nov 18.
The aims of this study were to estimate the incidence of the post-partum post-traumatic stress disorder (PP-PTSD) in primiparous women, and to determine the profile of women at risk of developing this disorder.
We conducted a descriptive, prospective and longitudinal study carried out at the maternity department of the Hedi Chaker Hospital, Sfax-Tunisia over a period of 15 months. At the first stage of the study, the Saint-Antoine pain questionnaire, the peri-traumatic dissociative experiences questionnaire and the peri-traumatic distress inventory were used respectively to assess the pain of delivery, the peri-traumatic dissociation and distress. At the second stage of the study, the questionnaires, perinatal post-traumatic stress disorder (PPQ), hospital anxiety and depression scale and the Edinburgh postnatal depression scale were used respectively for the PP-PTSD screening and the assessment of the post-partum anxious and depressive symptomatology.
The study population consisted of 183 parturients at the first stage of the study and 150 parturients at the second stage of the study. The incidence of the PP-PTSD was 9.3 %. In the multivariate study, some factors studied were significantly associated with the development of PTSD-PP, including a history of therapeutic termination of pregnancy, a history of miscarriage, exposure to a stressful event during pregnancy, prenatal hospitalization of the mother, instrumental delivery, pain intensity especially in the affective component, peri-traumatic dissociation and avoidance of sexual intercourse for fear of a new pregnancy. However the skin to skin contact with the new-born immediately after delivery was a significant protective factor.
The psychological consequences associated with the first birth, particularly the PP-PTSD, are common. The Identification of women at risk and a systematic screening of postpartum post-traumatic stress symptoms are desirable.
本研究旨在评估初产妇产后创伤后应激障碍（PP-PTSD）的发病率，并确定有患该障碍风险的女性特征。
我们在突尼斯斯法克斯市赫迪·查克医院产科进行了一项为期15个月的描述性、前瞻性纵向研究。在研究的第一阶段，分别使用圣安托万疼痛问卷、创伤周围解离经历问卷和创伤周围痛苦量表来评估分娩疼痛、创伤周围解离和痛苦。在研究的第二阶段，分别使用围产期创伤后应激障碍问卷（PPQ）、医院焦虑抑郁量表和爱丁堡产后抑郁量表进行PP-PTSD筛查以及评估产后焦虑和抑郁症状。
研究人群在第一阶段有183名产妇，第二阶段有150名产妇。PP-PTSD的发病率为9.3%。在多变量研究中，一些研究因素与PTSD-PP的发生显著相关，包括治疗性终止妊娠史、流产史、孕期暴露于应激事件、母亲产前住院、器械分娩、疼痛强度尤其是情感成分、创伤周围解离以及因害怕再次怀孕而避免性交。然而，产后立即与新生儿进行皮肤接触是一个显著的保护因素。
与首次分娩相关的心理后果，尤其是PP-PTSD很常见。识别有风险的女性并对产后创伤后应激症状进行系统筛查是很有必要的。
