父母中与分娩相关的创伤后应激障碍的流行率和风险因素:一项比较系统的综述和荟萃分析。
Prevalence and risk factors of birth-related posttraumatic stress among parents: A comparative systematic review and meta-analysis.
机构信息
Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Germany.
Institute of Psychology, University of Gdansk, Poland.
出版信息
Clin Psychol Rev. 2022 Jun;94:102157. doi: 10.1016/j.cpr.2022.102157. Epub 2022 Apr 21.
This systematic review and meta-analysis aimed to determine mean estimates of prevalence rates for fulfilling all diagnostic criteria of posttraumatic stress disorder (PTSD) or at least showing significant levels of posttraumatic stress (PTSS) in relation to the traumatic event of childbirth. For the first time, both mothers and fathers were included in the synthesis. Studies were identified through systematic database search and manual searches, irrespective of language. Meta-analyses of 154 studies (N = 54,711) applied a random-effects model to four data sets, resulting in pooled prevalence rates of 4.7% for PTSD and 12.3% for PTSS in mothers. Lower rates of 1.2% for PTSD and 1.3% for PTSS were found among fathers. Subgroup analyses showed elevated rates in targeted samples (those with a potential risk status) most distinctly for maternal PTSS. The significant amount of heterogeneity between studies could not be explained to a satisfactory degree through meta-regression. Given the substantial percentage of affected parents, the adoption of adequate prevention and intervention strategies is needed. As this field of research is evolving, attention should be broadened to the whole family system, which may directly and indirectly be affected by birth-related PTSD. Further studies on paternal PTSD/PTSS are particularly warranted.
本系统评价和荟萃分析旨在确定满足创伤后应激障碍(PTSD)所有诊断标准或至少表现出显著创伤后应激(PTSS)水平的发生率的平均值估计值,这些诊断标准与分娩这一创伤事件有关。这是第一次将母亲和父亲都纳入到综合分析中。通过系统的数据库搜索和手动搜索,无论语言如何,都确定了研究。对 154 项研究(N=54711)的荟萃分析应用随机效应模型对四个数据集进行分析,结果显示母亲 PTSD 的总患病率为 4.7%,PTSS 为 12.3%。父亲 PTSD 的患病率较低,为 1.2%,PTSS 为 1.3%。亚组分析显示,在有潜在风险的目标样本中(那些有潜在风险的样本),PTSS 的发生率明显升高,而 PTSD 的发生率则没有那么明显。研究之间存在大量的异质性,无法通过元回归得到满意的解释。鉴于受影响的父母比例相当大,需要采取适当的预防和干预策略。随着这一研究领域的发展,应该将注意力扩大到整个家庭系统,因为家庭系统可能会直接或间接地受到与生育相关的 PTSD 的影响。特别需要进一步研究父亲的 PTSD/PTSS。