Chen Jingfen, Wang Shu, Lai Xiaolu, Zou Linli, Wen Shi Wu, Krewski Daniel, Xie Ri-Hua
School of Nursing, Southern Medical University, Guangzhou, China.
Ottawa Hospital Research Institute, Ottawa, ON, Canada.
BMC Pregnancy Childbirth. 2024 Dec 28;24(1):874. doi: 10.1186/s12884-024-07088-5.
Postpartum post-traumatic stress disorder (PTSD) is a debilitating condition that can arise following childbirth. Despite a growing body of research on postpartum mental health, the relationship between social support and postpartum PTSD remains unclear. This study aimed to assess the association between social support and postpartum PTSD.
A prospective cohort study was conducted at a tertiary hospital in Guangdong province of China between November 2022 and April 2023. Eligible mothers were assessed for social support using the Social Support Rating Scale (SSRS) at three days postpartum and for PTSD using the Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) at 42 days postpartum. The association between social support and postpartum PTSD was analyzed using multiple linear and log-binomial regression, with adjustments for potential confounders.
Forty-six of 560 (8.2%) mothers developed PTSD within 42 days postpartum. Scores for subjective support (β=-0.319, P < 0.001), objective support (β=-0.327, P < 0.001), support availability (β=-0.285, P < 0.001), and overall social support score (β=-0.428, P < 0.001) were inversely associated with PTSD scores. Compared to mothers in the 1st quartile of the overall social support score, those in the 2nd, 3rd, and 4th quartiles had adjusted relative risks of 0.39 (95% confidence interval [CI]: 0.21-0.74), 0.20 (95% CI: 0.09-0.45), and 0.10 (95% CI: 0.03-0.33), respectively, of developing PTSD. An inverse linear trend in the risk of PTSD was observed with increasing social support (P-trend < 0.001).
Social support may have a protective effect against postpartum PTSD, with practical implications for interventions targeting various dimensions of support.
产后创伤后应激障碍（PTSD）是一种在分娩后可能出现的使人衰弱的病症。尽管关于产后心理健康的研究越来越多，但社会支持与产后创伤后应激障碍之间的关系仍不明确。本研究旨在评估社会支持与产后创伤后应激障碍之间的关联。
2022年11月至2023年4月期间，在中国广东省一家三级医院进行了一项前瞻性队列研究。符合条件的母亲在产后三天使用社会支持评定量表（SSRS）评估社会支持情况，并在产后42天使用围产期创伤后应激障碍问卷（PPQ）评估创伤后应激障碍情况。使用多元线性回归和对数二项回归分析社会支持与产后创伤后应激障碍之间的关联，并对潜在混杂因素进行调整。
560名母亲中有46名（8.2%）在产后42天内患上创伤后应激障碍。主观支持得分（β=-0.319，P<0.001）、客观支持得分（β=-0.327，P<0.001）、支持利用度得分（β=-0.285，P<0.001）和总体社会支持得分（β=-0.428，P<0.001）与创伤后应激障碍得分呈负相关。与总体社会支持得分处于第一四分位数的母亲相比，处于第二、第三和第四四分位数的母亲患创伤后应激障碍的调整后相对风险分别为0.39（95%置信区间[CI]：0.21-0.74）、0.20（95%CI：0.09-0.45）和0.10（95%CI：0.03-0.33）。随着社会支持增加，观察到创伤后应激障碍风险呈负线性趋势（P趋势<0.001）。
社会支持可能对产后创伤后应激障碍具有保护作用，这对针对支持的各个维度的干预措施具有实际意义。
