剖腹产全身麻醉与产后抑郁症和自杀倾向的关联
Jean Guglielminotti1, Catherine Monk2,3,4, Matthew T Russell1
1From the Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
剖腹产全身麻醉 (GA) 增加了需要住院和自杀的产后抑郁症 (PPD) 的风险. 尽可能避免GA和对PPD的查对于母亲的心理健康至关重要.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 精神病学是一个精神病学.
背景情况:
- 剖腹产全身麻醉 (GA) 与神经轴麻醉相比,与更高的产后抑郁症 (PPD) 率有关.
- 产科并发症可能会混GA和PPD之间的关联.
- 这项研究调查了GA与PPD的独立关联,解释了并发症.
研究的目的:
- 评估GA在剖腹产和需要住院治疗的PPD,门诊访问或急诊室 (ED) 访问之间的关联.
- 评估GA对需要再入院和自杀倾向的PPD的影响.
- 在分析中控制产科并发症.
主要方法:
- 在纽约州 (2009-2017) 接受剖腹产的妇女的回顾性队列研究.
- 退院后一年的随访,对与PPD相关的医疗保健利用和自杀倾向.
- 倾向性得分匹配和重叠倾向性得分权重用于调整混因素.
主要成果:
- 在6.0%的剖腹产中使用全身麻醉 (GA).
- GA与38%的需要住院治疗的PPD风险增加有关 (aHR: 1.38).
- 使用GA还显示,自杀倾向的风险增加了45% (aHR:1.45).
结论:
- 剖腹产的全身麻醉 (GA) 是PPD需要住院和自杀的独立风险因素.
- 建议在剖腹产中尽量减少GA的使用.
- 对于PPD和心理健康转诊的后GA查是必不可少的.
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