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急诊入院后产后创伤后应激障碍的危险因素。

Risk factors for postpartum posttraumatic stress disorder after emergency admission.

作者信息

Du Fengxia, Zha Jun, Li Yan, Fang Lichao, Xia Shuyu, Yu Youjia

机构信息

Department of Obstetrics, Suzhou Xiangcheng People's Hospital, Suzhou 215131, China.

Department of Anesthesiology, the Second Affiliated Hospital of Wannan Medical College, Wuhu 241000, China.

出版信息

World J Emerg Med. 2024;15(2):121-125. doi: 10.5847/wjem.j.1920-8642.2024.013.

Abstract

BACKGROUND

Postpartum posttraumatic stress disorder (PTSD) can occur in women who give birth after emergency admission. The identification of risk factors for this condition is crucial for developing effective preventive measures. This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.

METHODS

Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023. The patients' general conditions and perinatal clinical indicators were recorded. The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum. Multivariate logistic regression analysis was performed to identify risk factors.

RESULTS

A total of 276 puerperae were included, with a PTSD incidence of 20.3% at six weeks postpartum. Multivariate logistic regression analysis identified emergency cesarean section (odds ratio []=2.102; 95% confidence interval []: 1.114-3.966, =0.022), admission to the emergency department after midnight (12:00 AM) (=2.245; 95%: 1.170-4.305, <0.001), and cervical dilation (=3.203; 95% 1.670-6.141, =0.039) as independent risk factors for postpartum PTSD. Analgesia pump use ( 0.500; 95% 0.259-0.966, =0.015) was found to be a protective factor against postpartum PTSD.

CONCLUSION

Emergency cesarean section, admission to the emergency department after midnight, and cervical dilation were identified as independent risk factors for postpartum PTSD, while analgesic pump use was a protective factor. These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.

摘要

背景

产后创伤后应激障碍(PTSD)可发生于急诊入院后分娩的女性。识别该疾病的危险因素对于制定有效的预防措施至关重要。本回顾性研究旨在探讨急诊入院后分娩的女性产后PTSD的发病率及危险因素。

方法

收集2021年3月至2023年4月期间急诊入院后分娩的女性的病历。记录患者的一般情况及围产期临床指标。根据产后六周时的症状发生情况将产妇分为PTSD组和对照组。进行多因素logistic回归分析以识别危险因素。

结果

共纳入276名产妇,产后六周时PTSD发病率为20.3%。多因素logistic回归分析确定急诊剖宫产(比值比[]=2.102;95%置信区间[]:1.114 - 3.966,=0.022)、午夜(凌晨12:00)后入住急诊科(=2.245;95%:1.170 - 4.305,<0.001)及宫颈扩张(=3.203;95% 1.670 - 6.141,=0.039)为产后PTSD的独立危险因素。发现使用镇痛泵(0.500;95% 0.259 - 0.966,=0.015)是预防产后PTSD的保护因素。

结论

急诊剖宫产、午夜后入住急诊科及宫颈扩张被确定为产后PTSD的独立危险因素,而使用镇痛泵是保护因素。这些发现为为急诊入院后分娩的女性制定更有效的预防措施提供了见解。

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