Bodin E, Peretti V, Rouillay J, Tran P L, Boukerrou M
Service de PMA, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
Service de gynécologie obstétrique, CHU Sud Réunion, avenue François-Mitterrand, 97410 Saint-Pierre, Réunion.
Gynecol Obstet Fertil Senol. 2022 Mar;50(3):240-260. doi: 10.1016/j.gofs.2021.12.015. Epub 2022 Jan 10.
Posttraumatic stress disorder (PTSD) is declared in 3 to 6 % of postpartum women (PP) and up to 18.5 % in cases of complications of pregnancy or childbirth. The objective of this study is to assess the prevalence of PTSD after a red code cesarean section and to identify the risk factors among the prenatal vulnerability factors, the birth alert factors and the maintenance factors in PP.
A phone or computerized questionnaire including an Questionnaire de stress immédiat and the Posttraumatic Stress Disorder Checklist for DSM-5 was offered to patients who had a red code cesarean section between 05/12/2015 and 02/28/2021 at the University South Hospital of Reunion Island.
Among the 555 cesarean sections selected, 329 parturients responded. The prevalence of PTSD was 20.1 % and was stable over time. The 2 risk factors found were the negative experience of childbirth and the proven traumatic experience. Prenatal vunerability factors were not found to be statistically significant. Almost 3 in 4 women had not been informed of the risk of cesarean section and more than 1 in 2 women did not have an explanation in PP.
Red code cesarean sections cause PTSD in 1 in 5 women. This lasting disorder can last up to 6 years after childbirth. This indicates the seriousness of this disorder and the need to prevent it. The risk of developing it is 4 times greater in the event of a traumatic experience proven in the Questionnaire de stress immédiat. Offering this questionnaire in the maternity could be an important element of secondary prevention. The role of health personnel remains essential.
创伤后应激障碍（PTSD）在3%至6%的产后女性中被诊断出，在妊娠或分娩并发症的情况下，这一比例高达18.5%。本研究的目的是评估红色代码剖宫产术后PTSD的患病率，并确定产前易患因素、分娩警报因素和产后维持因素中的风险因素。
向2015年12月5日至2021年2月28日在留尼汪岛大学南部医院接受红色代码剖宫产的患者提供一份电话或计算机化问卷，其中包括一份即时应激问卷和《精神疾病诊断与统计手册》第5版创伤后应激障碍检查表。
在选定的555例剖宫产中，329名产妇做出了回应。PTSD的患病率为20.1%，且随时间保持稳定。发现的两个风险因素是分娩的负面经历和经证实的创伤经历。未发现产前易患因素具有统计学意义。近四分之三的女性未被告知剖宫产的风险，超过二分之一的女性在产后没有得到解释。
红色代码剖宫产导致五分之一的女性患PTSD。这种持续性疾病在产后可持续长达6年。这表明了这种疾病的严重性以及预防的必要性。在即时应激问卷中经证实有创伤经历的情况下，患PTSD的风险会增加4倍。在产科提供这份问卷可能是二级预防的一个重要因素。卫生人员的作用仍然至关重要。
