Department of Research, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA.
UMass Chan Medical School, Department of Population and Quantitative Health Sciences (PQHS), Worcester, Massachusetts, USA.
J Womens Health (Larchmt). 2022 Oct;31(10):1507-1517. doi: 10.1089/jwh.2021.0209. Epub 2022 Feb 25.
Many pregnant and postpartum Veterans have experienced multiple lifetime traumas, including military sexual trauma, intimate partner violence, and combat trauma. These women may be particularly vulnerable to increased post-traumatic stress disorder and other mental health problems following additional trauma exposures or stressful events, such as Coronavirus disease 2019 (COVID-19). This study sought to examine the impact of prior trauma exposures on the lived experience of pregnant and postpartum Veterans during the COVID-19 pandemic. Pregnant Veterans at 15 VA medical centers were surveyed at 20 weeks of pregnancy and 3 months postpartum asked about their COVID-19-related perinatal and mental health experiences, as well as the stressors that impacted them as a result of the COVID-19 pandemic. Overall, 111 women Veterans completed both the pregnancy and postpartum surveys that included COVID-19 items. Sixty percent of our sample had experienced at least one potentially traumatic lifetime event, with 22% of our sample experiencing two or more of the included exposures. Women with a trauma history had 3.5 times increased odds of reporting their mental health as "much worse" compared to before the COVID-19 pandemic (95% confidence interval [CI]: 1.06-11.75) and were more likely to report that COVID-19 negatively affected their mental or emotional health "a lot" compared with women without a trauma history (odds ratio: 8.5; 95% CI: 1.93-37.48). COVID-19 has had a significant impact on pregnant and postpartum Veterans' mental health. Obstetricians should consider strategies to ensure women have access to mental health care during pregnancy, especially as the COVID-19 pandemic continues. Hospitals should also consider the importance of labor support companions during the COVID-19 pandemic and examine adjusting policies to allow for at least one labor support companion during labor and delivery.
许多怀孕和产后的退伍军人经历过多次终生创伤，包括军事性创伤、亲密伴侣暴力和战斗创伤。这些女性在经历其他创伤暴露或压力事件（如 2019 年冠状病毒病（COVID-19））后，可能特别容易患上创伤后应激障碍和其他心理健康问题。本研究旨在探讨先前创伤暴露对 COVID-19 大流行期间怀孕和产后退伍军人生活经历的影响。在 15 个退伍军人事务部医疗中心的怀孕退伍军人在怀孕 20 周和产后 3 个月接受调查，询问他们与 COVID-19 相关的围产期和心理健康体验，以及因 COVID-19 大流行而影响他们的压力源。总体而言，有 111 名女性退伍军人完成了包括 COVID-19 项目的妊娠和产后调查。我们样本的 60%至少经历过一次潜在的创伤性终生事件，我们样本中有 22%经历过两次或更多次包括的暴露。有创伤史的女性报告其心理健康状况“明显恶化”的可能性是 COVID-19 大流行前的 3.5 倍（95%置信区间[CI]：1.06-11.75），并且与没有创伤史的女性相比，更有可能报告 COVID-19 对她们的心理健康或情绪健康“有很大影响”（比值比：8.5；95%CI：1.93-37.48）。COVID-19 对怀孕和产后退伍军人的心理健康产生了重大影响。妇产科医生应考虑确保女性在怀孕期间获得心理健康护理的策略，尤其是在 COVID-19 大流行继续期间。医院还应考虑在 COVID-19 大流行期间劳动支持同伴的重要性，并研究调整政策，以允许至少有一名劳动支持同伴在分娩和分娩期间陪伴。
