与分娩相关的创伤后应激障碍的跨国风险因素:INTERSECT研究的发现
Jonathan E Handelzalts1, Susan Ayers2, Rebecca Webb2
1School of Behavioral Sciences, https://ror.org/04cg6c004Academic College of Tel, Aviv-Yafo, Israel.
Psychological medicine
|November 17, 2025
概括
与分娩相关的创伤后应激障碍 (CB-PTSD) 受先前存在的脆弱性影响,但负面的出生经历是最强的预测因素. 创伤知情护理应该解决这些压力因素以及妇女对分娩的看法.
科学领域:
- 围产期心理健康问题
- 心理创伤学 心理创伤学
- 全球妇女健康问题
背景情况:
- 与分娩相关的创伤后应激障碍 (CB-PTSD) 是一种影响母亲和婴儿福祉的重要但未被认可的疾病.
- 了解风险因素对于开发有效的干预措施和支持系统至关重要.
研究的目的:
- 用压力诊断框架确定CB-PTSD症状的关键风险因素.
- 调查各种国际环境中CB-PTSD的产前,产后和产后预测因素.
主要方法:
- 跨截面调查 (INTERSECT) 在31个国家对11,302名分娩后6-12周的妇女进行.
- 评估了CB-PTSD诊断,症状严重程度,并使用城市出生创伤量表来感知创伤性分娩.
- 分析了多种风险因素,包括脆弱性和与怀孕,分娩和婴儿相关的因素,并调整了国家一级的差异.
主要成果:
- 负面的出生经历是CB-PTSD诊断的最强预测因素 (OR=0.82).
- 持续的母亲并发症 (OR=1.61) 和主要的婴儿并发症 (OR=1.63) 显著预测了CB-PTSD诊断和症状.
- 在出生期间感知到的危险与较高的CB-PTSD症状和创伤性出生评级 (β=0.25) 密切相关.
结论:
- 研究结果支持压力-诊断模型,强调与出生有关的压力因素是对先前存在的脆弱性的主要影响.
- 强调需要以创伤为基础的产妇护理,优先考虑分娩经历和女性的主观评估.
- 建议针对性干预,重点关注负面的出生事件和母亲/婴儿并发症,以减轻CB-PTSD.
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