剖宫产手术患者术前焦虑与产后抑郁的关联机制与研究进展

The Association between Preoperative Anxiety and Postpartum Depression in Cesarean Section Patients: Mechanisms and Research Progress

摘要: 剖宫产术(Cesarean Section, CS)作为全球21.1%的分娩方式，其术前焦虑发生率高达73.3%~86%，且与产后抑郁(Postpartum Depression, PPD)风险显著相关。研究表明，术前焦虑通过生理应激(如HPA轴激活致皮质醇升高)和心理机制(疼痛灾难化、自我效能损耗)增加PPD风险，尤其是紧急剖宫产因创伤性体验进一步放大此关联。本文综述了剖宫产术前焦虑与产后抑郁的流行病学特征、潜在关联机制及干预策略。然而，领域内存在方法学争议(如焦虑量表异质性)和临床转化障碍(VR成本效益矛盾)。未来需整合生物-心理模型，优化围术期心理评估路径，并扩大干预措施的普适性研究。

Abstract: Cesarean section (CS), which accounts for 21.1% of deliveries worldwide, has a preoperative anxiety rate as high as 73.3%~86% and is significantly associated with the risk of postpartum depression (PPD). Research indicates that preoperative anxiety increases the risk of PPD through physiological stress (such as activation of the HPA axis leading to elevated cortisol levels) and psychological mechanisms (pain catastrophizing, diminished self-efficacy), particularly in emergency cesarean sections where traumatic experiences further amplify this association. This article reviews the epidemiological characteristics, potential underlying mechanisms, and intervention strategies related to preoperative anxiety and postpartum depression in cesarean sections. However, the field faces methodological controversies (e.g., heterogeneity of anxiety scales) and clinical translation challenges (e.g., cost-effectiveness contradictions of virtual reality interventions). Future research should integrate bio-psychological models, optimize perioperative psychological assessment pathways, and expand studies on the generalizability of intervention measures.