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首页> 外文期刊>BMC Pregnancy and Childbirth >The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review
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The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review

机译：选择性剖宫产对产妇恐惧症对产妇焦虑和抑郁的产妇要求的影响：系统评价

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Background Obstetricians are often reluctant to grant requests for an elective cesarean section (ECS) due to childbirth fear. To date, it is unknown if an ECS on request improves mental well-being in the mother in the peripartum period and if possible beneficial effects on anxiety and depression could outweigh the increased risk of complications associated with a surgical delivery. A systematic review was conducted to explore the effect of ECS on request on peripartum anxiety and depression. Methods We searched on PubMed, PsychoInfo and Embase. Studies were included with primary data on anxiety and/or depression postpartum in women with childbirth fear who had requested an ECS. After full-text evaluation of 65 papers and quality analysis of four papers, three papers were included. Of one paper additional and yet unpublished data were provided. Studies varied in outcome measures, hence no meta-analysis was performed. Results Women who requested an ECS had higher antepartum depression and anxiety levels but no different postpartum depression levels than women who delivered vaginally. One study of good quality examined the effect of vaginal delivery in women preferring ECS: These women had significantly higher symptom levels of post-traumatic stress disorder (PTSD) and depression than women with normal vaginal delivery. Conclusions The prospect of an ECS does not lower antepartum anxiety and/or depression levels in women requesting an ECS. If women resolutely persist in wishing an ECS despite adequate counselling and/or psychiatric treatment, the risk of developing depressive and PTSD symptoms in case of vaginal delivery should be taken into account, and an ECS may be considered as a valid alternative.
机译：背景技术由于担心分娩，妇产科医生通常不愿接受选择性剖宫产（ECS）的请求。迄今为止，尚不清楚是否可以应要求提供ECS来改善围产期母亲的心理健康，并且如果可能，对焦虑和抑郁的有益影响可能超过手术分娩带来的并发症风险增加。进行了系统的审查，以探讨按要求提供的ECS对围产期焦虑和抑郁的影响。方法我们搜索了PubMed，PsychoInfo和Embase。纳入研究的主要数据包括请求ECS的分娩恐惧症妇女产后焦虑和/或抑郁的资料。在对65篇论文进行全文评估并对4篇论文进行质量分析后，纳入了3篇论文。在一篇论文中，提供了其他但尚未发表的数据。研究的结局指标不尽相同，因此未进行荟萃分析。结果要求进行ECS的女性与经阴道分娩的女性相比，产前抑郁和焦虑水平更高，但产后抑郁水平没有差异。一项高质量的研究检查了阴道分娩对偏爱ECS的女性的影响：这些女性的创伤后应激障碍（PTSD）和抑郁症状水平明显高于正常阴道分娩的女性。结论ECS的前景不会降低要求ECS的女性的产前焦虑和/或抑郁水平。如果尽管进行了充分的咨询和/或精神病治疗，妇女仍然坚决希望拥有ECS，则应考虑在阴道分娩的情况下出现抑郁和PTSD症状的风险，并且可以将ECS视为有效的替代选择。

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