A comparison of maternal and neonatal outcomes of pregnancy with mental disorders: results of an analysis using propensity score-based weighting
A comparison of maternal and neonatal outcomes of pregnancy with mental disorders: results of an analysis using propensity score-based weighting
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DOI：
10.1007/s00404-014-3304-7
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发表时间：
2014-11-01
影响因子：
2.6
通讯作者：
Takemura, Masahiko
中科院分区：
文献类型：
--
作者：
Kitai, Toshihiro;Komoto, Yoshiko;Takemura, Masahiko
目的评估和比较妊娠合并或不合并精神疾病的孕产妇和新生儿结局。方法我们对2009年1月至2011年12月在我院出生的所有活产单胎婴儿进行了回顾性队列研究。在怀孕中期紧急转移到我们机构的妇女被排除在外。精神障碍和围产期结局之间的关联估计使用统计分析，和多变量分析进行了使用倾向评分为基础的weighting.Results共1,166名妇女，其中152人（13.0%）有精神障碍。产妇特征的比较表明，精神障碍的妇女显着更有可能是多产，吸烟者，公共援助的接受者，未婚，并有不充分的围产期保健。两组围生儿结局比较显示，有精神障碍的孕妇孕37周前的早产（PTB）显著增加（10.5% vs.6.0%，P = 0.037）。在低出生体重（LBW）、妊娠高血压和妊娠期糖尿病方面无显著差异。采用倾向评分加权的多变量分析显示，在调整其他因素后，有精神障碍的女性比无精神障碍的女性更容易在34周前患PTB [调整后的比值比（OR）4. 79，95%置信区间（CI）1. 49 - 15. 4; P = 0.009]，37周前PTB（调整OR 2.46，95%CI 1.62-3.69; P < 0.001），或LBW（校正OR 1.83; 95%CI 1.32-2.55; P < 0.001）。结论母亲精神障碍与不良的生育结局和社会经济地位有关。
Purpose To assess and compare maternal and neonatal outcomes of pregnancy with or without mental disorders.Methods We performed a retrospective cohort study of births at our institution from January 2009 to December 2011, which included all live singleton births during these 3 years. Women emergently transferred to our institution in the middle of their pregnancies were excluded. Associations between mental disorders and perinatal outcomes were estimated using statistical analysis, and multivariable analysis was performed using propensity score-based weighting.Results A total of 1,166 women were included, 152 (13.0 %) of whom had mental disorders. Comparison of maternal characteristics showed that women with mental disorders were significantly more likely to be multiparous, smokers, recipients of public assistance, unmarried, and to have inadequate perinatal care. Comparison of perinatal outcomes showed that preterm births (PTB) before 37 weeks were significantly increased in women with mental disorders (10.5 vs. 6.0 %, P = 0.037). There were no significant differences in low birth weight (LBW), pregnancy-induced hypertension, and gestational diabetes mellitus. Multivariable analysis using propensity score weighting showed that after adjusting for other factors, women with mental disorders were more likely than women without mental disorders to have PTB before 34 weeks [adjusted odds ratio (OR) 4.79, 95 % confidence interval (CI) 1.49-15.4; P = 0.009], PTB before 37 weeks (adjusted OR 2.46, 95 % CI 1.62-3.69; P < 0.001), or LBW (adjusted OR 1.83; 95 % CI 1.32-2.55; P < 0.001).Conclusion Maternal mental disorders were associated with adverse birth outcomes and socioeconomic disadvantage.