PDF(Pubmed)
Abstract：
Background: Mental health disorders are the number one cause of maternal mortality and a significant maternal morbidity. This scoping review sought to understand the associations between social context and experiences during pregnancy and birth, biological indicators of stress and weathering, and perinatal mood and anxiety disorders (PMADs). Methods: A scoping review was performed using PRISMA-ScR guidance and JBI scoping review methodology. The search was conducted in OVID Medline and Embase. Results: This review identified 74 eligible English-language peer-reviewed original research articles. A majority of studies reported significant associations between social context, negative and stressful experiences in the prenatal period, and a higher incidence of diagnosis and symptoms of PMADs. Included studies reported significant associations between postpartum depression and prenatal stressors (n = 17), socioeconomic disadvantage (n = 14), negative birth experiences (n = 9), obstetric violence (n = 3), and mistreatment by maternity care providers (n = 3). Birth-related post-traumatic stress disorder (PTSD) was positively associated with negative birth experiences (n = 11), obstetric violence (n = 1), mistreatment by the maternity care team (n = 1), socioeconomic disadvantage (n = 2), and prenatal stress (n = 1); and inverse association with supportiveness of the maternity care team (n = 5) and presence of a birth companion or doula (n = 4). Postpartum anxiety was significantly associated with negative birth experiences (n = 2) and prenatal stress (n = 3). Findings related to associations between biomarkers of stress and weathering, perinatal exposures, and PMADs (n = 14) had mixed significance. Conclusions: Postpartum mental health outcomes are linked with the prenatal social context and interactions with the maternity care team during pregnancy and birth. Respectful maternity care has the potential to reduce adverse postpartum mental health outcomes, especially for persons affected by systemic oppression.
摘要：
背景：精神健康障碍是孕产妇死亡的头号原因，也是孕产妇发病率的重要原因。这项范围审查旨在了解怀孕和分娩期间社会背景与经历之间的关联，胁迫和风化的生物学指标，围产期情绪和焦虑症（PMAD）。方法：使用PRISMA-ScR指导和JBI范围审查方法进行范围审查。搜索在OVIDMedline和Embase中进行。结果：这篇综述确定了74篇合格的英语同行评审的原始研究文章。大多数研究报告了社会背景之间的显著关联，产前负面和紧张的经历，和更高的发病率的诊断和症状的PMAD。纳入的研究报告了产后抑郁和产前应激源之间的显著关联（n=17），社会经济劣势(n=14)，负出生经历(n=9)，产科暴力（n=3），和产妇护理提供者的虐待(n=3)。出生相关的创伤后应激障碍（PTSD）与负出生经历呈正相关（n=11），产科暴力（n=1），产妇护理团队的虐待(n=1)，社会经济劣势(n=2)，和产前压力（n=1）；与产妇护理团队的支持（n=5）和分娩伴侣或导乐的存在（n=4）呈负相关。产后焦虑与阴性分娩经历（n=2）和产前压力（n=3）显着相关。与压力和风化的生物标志物之间的关联相关的发现，围产期暴露，和PMADs(n=14)具有混合意义。结论：产后心理健康结局与产前社会背景以及怀孕和分娩期间与产妇护理团队的互动有关。适当的产妇护理有可能减少不良的产后心理健康结果，特别是受系统压迫的人。
