Perineal tear and childbirth-related posttraumatic stress: A prospective cohort study

IF 5.3 2区医学 Q1 PSYCHIATRY Acta Psychiatrica Scandinavica Pub Date : 2023-08-07 DOI:10.1111/acps.13595

Sophie Baumann, Andreas Staudt, Danny Horesh, Malin Eberhard-Gran, Susan Garthus-Niegel, Antje Horsch

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Abstract

Objective

Quantitative studies examining the occurrence of childbirth-related posttraumatic stress disorder (CB-PTSD) following severe perineal rupture are lacking. The objective of this population-based study was to investigate the prospective associations between the degree of perineal tear during childbirth and CB-PTSD symptoms, when adjusting for known covariates (maternal age, years of school education, premature birth, and parity). We hypothesized that women with different degrees of perineal tear will differ regarding (1) the level of CB-PTSD symptoms at 8 weeks and 2 years postpartum and (2) the rate of change in CB-PTSD symptoms from 8 weeks to 2 years postpartum.

Method

Secondary data analysis from the Akershus Birth Cohort, a large population-based prospective cohort study using self-report questionnaires and hospital record data.

Results

The degree of perineal tear was significantly associated with CB-PTSD symptoms at 8 weeks and 2 years postpartum. However, the degree of perineal tear was not significantly associated with the change in CB-PTSD symptoms over time. Similar patterns were found for both total CB-PTSD symptoms as well as for avoidance and intrusion symptoms only.

Conclusion

Results seem to support a dose–response model, suggesting that the higher the severity of the perineal tear, the higher the posttraumatic morbidity.

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会阴撕裂与分娩相关创伤后应激反应：前瞻性队列研究。

目的：目前还缺乏对严重会阴破裂后发生分娩相关创伤后应激障碍（CB-PTSD）的定量研究。这项基于人群的研究旨在调查分娩时会阴撕裂程度与 CB-PTSD 症状之间的前瞻性关联，同时调整已知的协变量（产妇年龄、受教育年限、早产和胎次）。我们假设，会阴撕裂程度不同的产妇在以下方面存在差异：(1) 产后 8 周和 2 年的 CB-PTSD 症状水平；(2) 产后 8 周至 2 年 CB-PTSD 症状的变化率：方法：对阿克苏斯出生队列进行二次数据分析，该队列是一项基于人口的大型前瞻性队列研究，使用的是自我报告问卷和医院记录数据：结果：会阴撕裂的程度与产后 8 周和 2 年的 CB-PTSD 症状有显著相关性。然而，会阴撕裂程度与 CB-PTSD 症状随时间的变化并无明显关联。在CB-创伤后应激障碍的全部症状以及回避和侵入症状方面也发现了类似的模式：结论：研究结果似乎支持剂量反应模型，即会阴撕裂程度越严重，创伤后发病率越高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.