围产期焦虑/抑郁与分娩疼痛相关性的研究现状

Current research status on correlation between perinatal anxiety/depression and labor pain

目围产期焦虑/抑郁是过度应激状态的不同表现形式,包括孕期焦虑/抑郁和产后焦虑/抑郁,它是指从妊娠开始至产后12个月这段时期女性对身体内外部压力事件的心身应激反应。若持续焦虑可能发展为过度焦虑,过度焦虑衰竭后,则可能发展为围产期焦虑/抑郁。围产期焦虑/抑郁的全球发病率为10%~21%,可增加女性产科疾病发生率,加重分娩疼痛,增加孕产妇自伤和自杀率等,还可能导致子代和家庭不良结局,造成严重社会负担,因此被临床日益重视。围产期焦虑/抑郁与多种因素相关,越来越多研究开始关注分娩疼痛(LP)与围产期焦虑/抑郁的关系。孕期焦虑/抑郁可能加重LP,也可能延续至产后,成为产后焦虑/抑郁,但是LP是否与产后焦虑/抑郁发生直接相关,则迄今尚存在争议。笔者拟从孕期焦虑/抑郁与LP的相关性、LP与产后焦虑/抑郁的相关性、孕期焦虑/抑郁与产后焦虑/抑郁的相关性这3方面入手,对围产期焦虑/抑郁与LP的最新研究现状进行阐述,旨在为相关临床研究提供参考。

Perinatal anxiety/depression is a different manifestation of excessive stress,including pregnancy anxiety/depression and postpartum anxiety/depression.It refers to a woman's psychosomatic stress response to internal and external stressful events from the beginning of pregnancy to 12 months after delivery.Perinatal anxiety may develop into excessive anxiety,and excessive anxiety failure may develop into perinatal anxiety/depression.The global incidence of perinatal anxiety/depression is about 10%-21%.Perinatal anxiety/depression can increase the incidence of obstetric diseases and aggravate labor pain in women,increase the rate of maternal self-injury and suicide,and may also lead to adverse outcomes in children and families,causing serious social burdens.Therefore,it has been paid more attention in clinic.Perinatal anxiety/depression is associated with many factors,and new studies have focused on the relationship between labor pain(LP)and perinatal anxiety/depression.Existing studies have shown that anxiety/depression during pregnancy can aggravate LP,which may also continue to postpartum as postpartum anxiety/depression.However,whether LP is directly related to postpartum anxiety/depression is controversial.The author intends to elaborate the latest research status of correlation between the perinatal anxiety/depression and LP from the following three aspects:the correlation between anxiety/depression during pregnancy and LP,the correlation between LP and postpartum anxiety/depression,and the correlation between anxiety/depression during pregnancy and postpartum anxiety/depression,in order to provide a reference for related further clinical research.