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一项关于分娩方式与产后创伤后应激障碍之间关联的前瞻性队列研究。

A prospective cohort study of the association between mode of delivery and postpartum posttraumatic stress disorder.

作者信息

Xu Baohong, Chen Yanfang, Tang Jiao

机构信息

Department of Emergency Medicine, Guangzhou Development District Hospital, Guangzhou, Guangdong, China.

Department of General Surgery, The Third Affiliated Hospital, Guangzhou Medical University, 63 Duobao Rd, Liwan, Guangzhou, 510150, Guangdong, China.

出版信息

Sci Rep. 2025 Feb 3;15(1):4149. doi: 10.1038/s41598-025-88717-7.

DOI:10.1038/s41598-025-88717-7
PMID:39900967
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11790957/
Abstract

Previous studies investigating the correlation between mode of delivery and posttraumatic stress disorder (PTSD) have yielded inconsistent results. This study aims to investigate the association between mode of delivery and PTSD in a cohort of Chinese women with a high rate of cesarean section (CS). We conducted a prospective cohort study in China between October 2019 and June 2021. Women aged 20-45 years who give birth at The Seventh Hospital of the Southern Medical University during the study period were enrolled. PTSD was assessed by the Posttraumatic Stress Disorder Checklist-Civilian Version at 42 days postpartum. We examined the independent association between mode of birth and PTSD by log-binomial regression analysis. A total of 759/800 (94.88%) women completed questionnaire. The prevalence of postpartum PTSD was 12.12% in included women, 8.18% in women with vaginal delivery (VD), 17.55% in women with CS. After adjusting for confounding factors, it was found that women with elective CS (RR = 1.70, 95%CI, 1.03 to 2.87) and emergency CS (RR = 1.95, 95%CI, 1.08 to 3.83) had an increased risk of developing postpartum PTSD compared with women with VD. CS is identified as an independent risk factor for PTSD in a cohort of Chinese women with a high prevalence of CS.

摘要

以往关于分娩方式与创伤后应激障碍(PTSD)之间相关性的研究结果并不一致。本研究旨在调查在中国剖宫产率较高的一组女性中,分娩方式与PTSD之间的关联。2019年10月至2021年6月期间,我们在中国进行了一项前瞻性队列研究。纳入了研究期间在南方医科大学第七附属医院分娩的20至45岁女性。产后42天通过创伤后应激障碍检查表-平民版评估PTSD。我们通过对数二项回归分析研究了分娩方式与PTSD之间的独立关联。共有759/800名(94.88%)女性完成了问卷调查。纳入女性中产后PTSD的患病率为12.12%,阴道分娩(VD)女性为8.18%,剖宫产(CS)女性为17.55%。在调整混杂因素后,发现与VD女性相比,择期剖宫产(RR = 1.70,95%CI,1.03至2.87)和急诊剖宫产(RR = 1.95,95%CI,1.08至3.83)的女性发生产后PTSD的风险增加。在剖宫产患病率较高的一组中国女性中,CS被确定为PTSD的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a094/11790957/afc12633a633/41598_2025_88717_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a094/11790957/0efe746c87f5/41598_2025_88717_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a094/11790957/1ecec92a1347/41598_2025_88717_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a094/11790957/afc12633a633/41598_2025_88717_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a094/11790957/0efe746c87f5/41598_2025_88717_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a094/11790957/1ecec92a1347/41598_2025_88717_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a094/11790957/afc12633a633/41598_2025_88717_Fig3_HTML.jpg

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本文引用的文献

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Risk factors for postpartum posttraumatic stress disorder after emergency admission.急诊入院后产后创伤后应激障碍的危险因素。
World J Emerg Med. 2024;15(2):121-125. doi: 10.5847/wjem.j.1920-8642.2024.013.
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Risk factors for failure of conversion from epidural labor analgesia to cesarean section anesthesia and general anesthesia incidence: an updated meta-analysis.硬膜外分娩镇痛中转剖宫产及全麻发生率失败的危险因素:一项更新的荟萃分析。
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Post-traumatic stress syndromes following childbirth influenced by birth mode-is an emergency cesarean section worst?
产后创伤后应激综合征与分娩方式有关——紧急剖宫产最糟糕吗?
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Arch Psychiatr Nurs. 2023 Jun;44:76-85. doi: 10.1016/j.apnu.2023.04.007. Epub 2023 Apr 23.
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Assessment of childbirth-related post traumatic stress disorder in Australian mothers: Psychometric properties of the City Birth Trauma Scale.澳大利亚母亲中与分娩相关的创伤后应激障碍评估:城市分娩创伤量表的心理测量特性。
J Affect Disord. 2023 Mar 1;324:559-565. doi: 10.1016/j.jad.2022.12.123. Epub 2022 Dec 28.
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A survey of perceived traumatic birth experiences in an Irish maternity sample - prevalence, risk factors and follow up.爱尔兰母婴样本中创伤性分娩经历的调查 - 患病率、风险因素和随访。
Midwifery. 2022 Oct;113:103419. doi: 10.1016/j.midw.2022.103419. Epub 2022 Jul 9.
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Childbirth experience, risk of PTSD and obstetric and neonatal outcomes according to antenatal classes attendance.根据产前班的参与情况,分娩经历、创伤后应激障碍风险以及产科和新生儿结局。
Sci Rep. 2022 Jun 23;12(1):10717. doi: 10.1038/s41598-022-14508-z.
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Postpartum PTSD and birth experience in Russian-speaking women.俄罗斯裔女性的产后创伤后应激障碍和分娩经历。
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