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COVID-19 大流行对疫情第一波期间分娩的孕妇的压力和其他心理因素的影响。

The impact of the COVID-19 pandemic on stress and other psychological factors in pregnant women giving birth during the first wave of the pandemic.

机构信息

Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany.

Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany.

出版信息

Reprod Health. 2022 Sep 5;19(1):189. doi: 10.1186/s12978-022-01493-9.

Abstract

BACKGROUND

The onset of mental illness such as depression and anxiety disorders in pregnancy and postpartum period is common. The coronavirus induced disease 2019 (COVID-19) pandemic and the resulting public policy responses represent an exceptional situation worldwide and there are hints for adverse psychosocial impact, hence, the study of psychological effects of the pandemic in women during hospitalization for delivery and in the postpartum period is highly relevant.

METHODS

Patients who gave birth during the first wave of the COVID-19 pandemic in Germany (March to June 2020) at the Department of Obstetrics and Gynecology, University of Würzburg, Germany, were recruited at hospital admission for delivery. Biosamples were collected for analysis of SARS-CoV-2 infection and various stress hormones and interleukin-6 (IL-6). In addition to sociodemographic and medical obstetric data, survey questionnaires in relation to concerns about and fear of COVID-19, depression, stress, anxiety, loneliness, maternal self-efficacy and the mother-child bonding were administered at T1 (delivery stay) and T2 (3-6 months postpartum).

RESULTS

In total, all 94 recruited patients had a moderate concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at T1 with a significant rise at T2. This concern correlated with low to low-medium general psychosocial stress levels and stress symptoms, and the women showed a significant increase of active coping from T1 to T2. Anxiety levels were low and the Edinburgh Postnatal Depression Scale showed a medium score of 5 with a significant (T1), but only week correlation with the concerns about SARS-CoV-2. In contrast to the overall good maternal bonding without correlation to SARS-CoV-2 concern, the maternal self-efficiency correlated negatively with the obstetric impairment caused by the COVID-19 pandemic.

CONCLUSION

Obstetric patients` concerns regarding SARS-CoV-2 and the accompanying pandemic increased during the course of the pandemic correlating positively with stress and depression. Of note is the increase in active coping over time and the overall good mother-child-bonding. Maternal self-efficacy was affected in part by the restrictions of the pandemic. Clinical trial registration DRKS00022506.

摘要

背景

在妊娠和产后期间,精神疾病如抑郁症和焦虑症的发病较为常见。2019 年冠状病毒病(COVID-19)大流行以及由此产生的公共政策反应是全球范围内的特殊情况,有迹象表明其对社会心理有不良影响,因此,研究大流行期间分娩和产后住院期间女性的心理影响具有高度相关性。

方法

德国维尔茨堡大学妇产科在 COVID-19 大流行的第一波期间(2020 年 3 月至 6 月)招募了在医院分娩的患者。采集生物样本用于分析 SARS-CoV-2 感染和各种应激激素和白细胞介素 6(IL-6)。除了社会人口统计学和医学产科数据外,还在 T1(分娩期间)和 T2(产后 3-6 个月)时通过问卷调查评估了与 COVID-19 相关的担忧和恐惧、抑郁、压力、焦虑、孤独、产妇自我效能和母婴联系。

结果

总共,所有 94 名入组患者在 T1 时对严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)有中度关注,在 T2 时明显增加。这种担忧与低至中低水平的一般社会心理压力水平和压力症状相关,并且女性在 T1 至 T2 期间积极应对的能力显著增强。焦虑水平较低,爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale)的评分为 5 分,具有显著意义(T1),但仅与对 SARS-CoV-2 的担忧存在周相关。与没有与 SARS-CoV-2 担忧相关的整体良好母婴联系不同,产妇自我效能与 COVID-19 大流行引起的产科损伤呈负相关。

结论

在大流行期间,产科患者对 SARS-CoV-2 的担忧及其伴随的大流行有所增加,这与压力和抑郁呈正相关。值得注意的是,随着时间的推移,积极应对的能力有所增强,母婴联系总体良好。产妇自我效能在一定程度上受到大流行限制的影响。临床试验注册 DRKS00022506。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c64f/9447343/a4ec33c25d26/12978_2022_1493_Fig1_HTML.jpg

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