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剖宫产分娩与产后女性创伤后应激障碍之间的关系。

The Relation between Birth with Cesarean Section and Posttraumatic Stress in Postpartum Women.

作者信息

Orovou Eirini, Iliadou Maria, Chatzopoulou Maria Tzitiridou, Dagla Maria, Eskitzis Panagiotis, Rigas Nikolaos, Antoniou Evangelia

机构信息

aDepartment of Midwifery, University of Western Macedonia, Keptse, 50200 Ptolemaida, Greece.

Department of Midwifery, University of West Attica, Agioy Spyridonos 28, 12243 Egaleo, Greece.

出版信息

Maedica (Bucur). 2023 Dec;18(4):615-622. doi: 10.26574/maedica.2023.18.4.615.

Abstract

The aim of this study was to investigate the relation between cesarean section and postpartum posttraumatic stress disorder as well as the factors that contribute to the development of posttraumatic symptoms in mothers. A sample of 538 women who gave birth with emergency and elective cesarean section in a University Hospital of Thessaly, Greece, have consented to participate in a two-phase prospective study. A socio-demographic questionnaire, the stressor Criterion A, the Life Events Checklist and the Posttraumatic Checklist of the fifth edition of the Diagnostic and Statistical Manual (DSM-5) were used to diagnose posttraumatic symptoms in Greek postpartum mothers. Out of 538 mothers, 37.2% had an emergency cesarean section and the remaining 62.8% an elective one. Posttraumatic stress was seen in 26 (26%) of women with emergency surgery and three (3%) of those with elective surgery. The present study also found that the inclusion of a neonate to the NICU, complications during pregnancy and delivery, lack of breastfeeding and lack of support from the partner were strongly associated with the development of posttraumatic symptoms. The results of the current study indicate the need to take measures to reduce cesarean section rates and promote vaginal delivery. The high posttraumatic stress rates make it imperative to take additional measures for the mental health of women after cesarean section, especially in those with a traumatic birth experience.

摘要

本研究的目的是调查剖宫产与产后创伤后应激障碍之间的关系,以及导致母亲出现创伤后症状的因素。在希腊色萨利大学医院,538名接受急诊和择期剖宫产分娩的女性样本同意参与一项两阶段前瞻性研究。使用一份社会人口统计学问卷、应激源A标准、生活事件清单和《精神疾病诊断与统计手册》(DSM-5)第五版的创伤后清单来诊断希腊产后母亲的创伤后症状。在538名母亲中,37.2%接受了急诊剖宫产,其余62.8%接受了择期剖宫产。急诊手术的女性中有26名(26%)出现创伤后应激,择期手术的女性中有3名(3%)出现创伤后应激。本研究还发现,新生儿入住新生儿重症监护病房、妊娠和分娩期间的并发症、缺乏母乳喂养以及伴侣缺乏支持与创伤后症状的发展密切相关。当前研究结果表明,有必要采取措施降低剖宫产率并促进阴道分娩。创伤后应激的高发生率使得必须针对剖宫产后女性的心理健康采取额外措施,尤其是那些有创伤性分娩经历的女性。

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