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首页> 外文期刊>PLoS One >Trait anxiety and unplanned delivery mode enhance the risk for childbirth-related post-traumatic stress disorder symptoms in women with and without risk of preterm birth: A multi sample path analysis
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Trait anxiety and unplanned delivery mode enhance the risk for childbirth-related post-traumatic stress disorder symptoms in women with and without risk of preterm birth: A multi sample path analysis

机译：特质焦虑和意外交付模式增强了与早产风险和患有早产的妇女的分娩后应激障碍症状的风险：多样本路径分析

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Childbirth-related post-traumatic stress disorder (CB-PTSD) occurs in 3–7% of all pregnancies and about 35% of women after preterm birth (PTB) meet the criteria for acute stress reaction. Known risk factors are trait anxiety and pain intensity, whereas planned delivery mode, medical support, and positive childbirth experience are protective factors. It has not yet been investigated whether the effects of anxiety and delivery mode are mediated by other factors, and whether a PTB-risk alters these relationships. 284 women were investigated antepartum and six weeks postpartum (risk-group with preterm birth (RG-PB) N = 95, risk-group with term birth (RG-TB) N = 99, and control group (CG) N = 90). CB-PTSD symptoms and anxiety were measured using standardized psychological questionnaires. Pain intensity, medical support, and childbirth experience were assessed by single items. Delivery modes were subdivided into planned vs. unplanned delivery modes. Group differences were examined using MANOVA. To examine direct and indirect effects on CB-PTSD symptoms, a multi-sample path analysis was performed. Rates of PTS were highest in the RG-PB = 11.58% (RG-TB = 7.01%, CG = 1.1%). MANOVA revealed higher values of CB-PTSD symptoms and pain intensity in RG-PB compared to RG-TB and CG. Women with planned delivery mode reported a more positive birth experience. Path modeling revealed a good model fit. Explained variance was highest in RG-PB ( R 2 = 44.7%). Direct enhancing effects of trait anxiety and indirect reducing effects of planned delivery mode on CB-PTSD symptoms were observed in all groups. In both risk groups, CB-PTSD symptoms were indirectly reduced via support by medical staff and positive childbirth experience, while trait anxiety indirectly enhanced CB-PTSD symptoms via pain intensity in the CG. Especially in the RG-PB, a positive birth experience serves as protective factor against CB-PTSD symptoms. Therefore, our data highlights the importance of involving patients in the decision process even under stressful birth conditions and the need for psychological support antepartum, mainly in patients with PTB-risk and anxious traits. Trial registration number: {"type":"clinical-trial","attrs":{"text":"NCT01974531","term_id":"NCT01974531"}} NCT01974531 (ClinicalTrials.gov identifier).
机译：与分娩相关的后创伤后应激障碍（CB-PTSD）在预怀孕的3-7％的3-7％和早产（PTB）后约35％的女性符合急性胁迫反应的标准。已知的风险因素是特质焦虑和疼痛强度，而计划的交付模式，医疗支持和积分分娩经验是保护因素。尚未调查焦虑和交付模式的影响是否由其他因素介导，以及PTB风险是否改变了这些关系。 284名妇女调查胃窦和产后六周（具有早产（RG-PB）N = 95的风险组，具有术语出生的风险组（RG-TB）N = 99，对照组（CG）n = 90） 。使用标准化的心理调查问卷测量CB-PTSD症状和焦虑。单一物品评估疼痛强度，医疗支持和分娩经验。交付模式被细分为计划与计划过多的交付模式。使用Manova检查组差异。为了检查对CB-PTSD症状的直接和间接影响，进行多样本路径分析。 Pts的速率最高，RG-Pb = 11.58％（RG-TB = 7.01％，CG = 1.1％）。 Manova与RG-TB和CG相比，RG-PB中的CB-PTSD症状和疼痛强度揭示了更高的CB-PTSD症状和疼痛强度。有计划交付模式的妇女报告了更积极的出生经验。路径建模显示出良好的型号合适。解释的差异在RG-Pb中最高（R 2 = 44.7％）。在所有群体中观察到既有特质焦虑和间接降低综合减少对CB-PTSD症状的间接减少效果的直接增强。在两个风险群体中，CB-PTSD症状通过医务人员和积分分娩经验间接减少，而特性焦虑通过CG中的疼痛强度间接增强CB-PTSD症状。特别是在RG-PB中，积极的出生经验是针对CB-PTSD症状的保护因素。因此，我们的数据突出了涉及患者在决策过程中涉及患者的重要性，即使在压力的出生条件下，患有心理支持患者的需求，主要是PTB风险和焦急性状的患者。试验登记号码：{“类型”：“临床试验”，“attrs”：{“text”：“nct01974531”，“term_id”：“nct01974531”}} nct01974531（ClinicalTrials.gov标识符）。

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