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硬膜外镇痛与产后 2 个月时的抑郁、创伤后应激障碍和母婴联系有关。

Epidural analgesia associations with depression, PTSD, and bonding at 2 months postpartum.

机构信息

School of Behavioral Sciences, Academic College of Tel-Aviv-Yafo, Tel-Aviv, Israel.

Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.

出版信息

J Psychosom Obstet Gynaecol. 2022 Dec;43(4):488-494. doi: 10.1080/0167482X.2022.2081146. Epub 2022 Jun 28.

DOI:10.1080/0167482X.2022.2081146
PMID:35762178
Abstract

The research aim was to study the possible effect of epidural analgesia, as well as other possible demographic/obstetric variables and subjective birth experience on postpartum depression, PTSD, and impaired bonding. This was a longitudinal study of 254 women who gave birth at the maternity wards of a large tertiary health center and responded to questionnaires at T1 (Childbirth Experience Questionnaire and level of fatigue question; in person, 1-4 days postpartum) and at T2 (Postnatal Depression Scale, Postpartum Bonding Questionnaire, and the City Birth Trauma Scale; online-two months postpartum). Obstetric and demographic data were taken from medical files. Having a previous psychiatric diagnosis and higher levels of fatigue significantly predicted worse outcomes in all measures (level of fatigue was not associated with the City Birth Trauma birth-related symptoms factor). Having higher education, being primiparous, worse birth experience, and longer second stage of birth predicted worse outcomes in some measures. Although epidural administration had no effect on any of the outcome variables, special attention should be devoted to women who had long second-stage births and/or suffering from postpartum fatigue to prevent postpartum psychopathology. In addition, demographic variables, such as primiparity, education, and prior psychopathology diagnosis should be considered to treat women and prevent postpartum psychopathology.

摘要

本研究旨在探讨硬膜外镇痛以及其他可能的人口统计学/产科变量和主观分娩体验对产后抑郁、创伤后应激障碍和母婴联系受损的可能影响。这是一项对 254 名在一家大型三级保健中心产科病房分娩的妇女进行的纵向研究,她们在 T1 时(分娩体验问卷和疲劳程度问题;分娩后 1-4 天,亲自)和 T2 时(产后抑郁量表、产后联系问卷和城市分娩创伤量表;在线,产后两个月)回答了问卷。产科和人口统计学数据来自病历。先前的精神科诊断和更高水平的疲劳显著预测了所有测量结果中的更差结局(疲劳水平与城市分娩创伤与分娩相关症状因素无关)。更高的教育程度、初产妇、更差的分娩体验和更长的第二产程预测了一些测量结果中的更差结局。虽然硬膜外给药对任何结果变量都没有影响,但应特别关注第二产程较长和/或产后疲劳的妇女,以预防产后精神病理学。此外,应考虑人口统计学变量,如初产妇、教育程度和先前的精神病理学诊断,以治疗妇女并预防产后精神病理学。

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