Kuhlmann Emily, Scharli Pauline, Schick Maren, Ditzen Beate, Langer Laila, Strowitzki Thomas, Wischmann Tewes, Kuon Ruben-J
Department of Gynecological Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany.
Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
Geburtshilfe Frauenheilkd. 2023 Jan 11;83(1):88-96. doi: 10.1055/a-1916-9180. eCollection 2023 Jan.
Recurrent pregnancy loss is usually associated with significant psychological distress for both partners of the couple. It may act as a traumatic experience resulting in a posttraumatic stress disorder. The object of this study is to examine the posttraumatic impact of recurrent pregnancy loss on men and women and their interdependencies. Cross-sectional study. All couples referred to the special unit for recurrent pregnancy loss between March 2019 and October 2020 were asked to participate with a sample size of 105 couples and 17 women. They were invited to complete a questionnaire package estimating the prevalence of posttraumatic stress, with anxiety, depression, lack of social support and dysfunctional coping strategies as contributing risk factors. Couple data were analysed with the Actor Partner Interdependence Model, taking the couple as a dyad. The response rate was 82.3 percent, with posttraumatic stress being measured in 13.7% of the women versus 3.9% of the men (p = 0.017). For women, number of curettages, controlled for the number of losses, correlated with the severity of posttraumatic stress (p < 0.05). Higher levels of anxiety, depression and lack of social support in women correlated positively with posttraumatic stress in their partners. The men's coping strategy "trivialization and wishful thinking" as well as "avoidance" correlated with more severe posttraumatic stress in the female partners (both p < 0.05). The posttraumatic risks within a couple with recurrent pregnancy loss are interdependent. Recurrent pregnancy loss clinics should assess posttraumatic risks of both partners in their routine diagnostic process.
复发性流产通常会给夫妻双方带来巨大的心理困扰。它可能成为一种创伤性经历,导致创伤后应激障碍。本研究的目的是探讨复发性流产对男性和女性的创伤后影响及其相互依存关系。横断面研究。2019年3月至2020年10月期间转诊至复发性流产专科单位的所有夫妇被邀请参与,样本量为105对夫妇和17名单身女性。他们被邀请完成一套问卷,评估创伤后应激障碍的患病率,焦虑、抑郁、缺乏社会支持和功能失调的应对策略是导致创伤后应激障碍的风险因素。夫妻数据采用 Actor Partner Interdependence Model进行分析,将夫妻视为一个二元组。回复率为82.3%,13.7%的女性存在创伤后应激障碍,而男性为3.9%(p = 0.017)。对于女性来说,在控制流产次数的情况下,刮宫次数与创伤后应激障碍的严重程度相关(p < 0.05)。女性较高水平的焦虑、抑郁和缺乏社会支持与伴侣的创伤后应激障碍呈正相关。男性的应对策略“轻视和一厢情愿”以及“回避”与女性伴侣更严重的创伤后应激障碍相关(均p < 0.05)。复发性流产夫妇中的创伤后风险是相互依存的。复发性流产诊所应在其常规诊断过程中评估双方的创伤后风险。