- 學位論文
婦女生產後創傷後壓力症候群之相關危險因子研究
The Risk Factors Associated with Post-Traumatic Stress Disorder after Childbirth among Women
摘要
研究目的：本研究旨在探討婦女生產後創傷後壓力症候群之危險因子，並了解 PTSD與基因多型性的關聯性。研究方法：本研究方法採橫斷式研究設計，收案時間自2010年1月1日至2011年6月30日止；收案條件為出生週數小於37週的早產兒母親和健康足月兒母親。利用具信、效度之結構式問卷，以面對面方式進行資料收集；並採集受試者血液，進行DRD2(rs6277)、DRD2(rs1800497)、GR(rs41423247)和FKBP5(rs1360780)之基因多型性分析。統計方法部分，根據變項特徵進行卡方檢定和t-檢定，以了解變項間之相關性，並以多變項邏輯斯迴歸估算各危險因子與勝算比。研究結果：本研究共招募213位母親，分別為早產兒母親102人，足月兒母親111人。整體母親創傷後壓力症候群的盛行率為8.5%，早產兒母親創傷後壓力症候群顯著高於足月兒母親（p = 0.031）。同時具神經質人格與憂鬱症狀者顯著影響創傷後壓力症候群的發生（OR = 6.75, 95% C.I. = 2.03-22.42）。當母親同時具FKBP5 (rs1360780) CT+TT與DRD2 (rs6277) CT+TT時，對其產後發生創傷後壓力症候群具統計顯著性（OR = 13.80, 95% C.I. = 2.06-92.68）。結論與建議：早產兒母親有較高創傷後壓力症候群風險，臨床上應盡早提供早產兒母親相關介入措施，以防創傷後壓力症候群發生。
並列摘要
Objective：This study aims to explore the risk factors of post-traumatic stress symptoms (PTSD) and the association between PTSD and gene polymorphysim. Material and methods: This is a cross-sectional case control study collecting data from January 1, 2010 till June 30, 2011. The mothers of preterm infant (gestational age < 37 weeks) and mothers of healthy full-term infant were recruited. This study collected data by using a well-structured questionnaire through face-to-face interview. The blood samples of participants were also collected to analyze gene polymorphysim. The polymorphysim includes DRD2(rs6277), DRD2(rs1800497), GR(rs41423247) and FKBP5(rs1360780). Correlations were examined by using chi-square test and t-test depending on the characteristics of the variables involved in the analysis. The multivariate logistic regression was used to calculate the odds ratios and related 95% confidence interval for the risk factors. Results: Two hundred and thirteen mothers were recruited, including 102 mothers of preterm infants and 111 mothers of full-term child. The prevalence of PTSD for all the participants was 8.5%. The preterm infants mothers had PTSD more than the fullterm infants mothers (p = 0.031). The neuroticism and depression symptoms was found highly correlated with PTSD (OR = 6.83; 95% C.I. = 2.06-22.59). Mothers of preterm infant simultaneously having FKBP5 (rs1360780) CT+TT and DRD2 (rs6277) CT+TT were found significantly correlated with PTSD (OR = 13.80; 95% C.I. = 2.06-92.68). Conclusion and Suggestion: This study revealed that preterm birth was associated with increased risk of PTSD. There is a need to provide early intervention to improve PTSD for mothers of preterm.