Prenatal Care and Adverse Pregnancy Outcomes Among Women With Depression: A Nationwide Population-based Study
Prenatal Care and Adverse Pregnancy Outcomes Among Women With Depression: A Nationwide Population-based Study
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DOI：
10.1177/070674371105600506
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发表时间：
2011-05-01
影响因子：
4
通讯作者：
Lin, Herng-Ching
中科院分区：
文献类型：
--
作者：
Chen, Chia-Hui;Lin, Herng-Ching
目的：评估产前护理的数量作为一个危险因素，分娩低出生体重（LBW），早产，小于胎龄儿（SGA）的样本中诊断为抑郁症的妇女。方法：我们的研究使用了一个基于人口的数据集，台湾的国民健康保险研究数据库，我们将其与台湾的出生证明登记处联系起来，确定了总共5283名患有抑郁症的新妈妈。进行多变量logistic回归分析，以测量与产前检查次数相关的LBW、早产和SGA婴儿的分娩风险（10个以上，8 ~ 9个，7个以下）。结果：在调整了女性的年龄、月收入、居住地的城市化水平、地理位置、婚姻状况、药物滥用等因素后，回归分析显示，有抑郁症史的母亲产前检查次数在7次及以下的孕妇，其患抑郁症的危险性为4.21（95% CI 3.34 - 5.32，P < 0.001），5.37（95% CI 4.33至6.67，P < 0.001）和2.41（95% CI 2.03 - 2.86，P < 0.001）分别是LBW、早产和SGA婴儿的可能性的两倍，与接受产前检查10次或以上的抑郁症母亲相比。结论：有抑郁症病史的母亲，产前检查次数较少，LBW、SGA和早产的风险增加，与有抑郁症病史的妇女进行了足够数量的产前检查相比。
Objective: To evaluate the quantity of prenatal care as a risk factor for giving birth to low birth weight (LBW), preterm, and small for gestational age (SGA) infants in a sample of women diagnosed with depressive disorder.Method: Our study used a population-based dataset, Taiwan's National Health Insurance Research Database, which we linked to Taiwan's birth certificate registry to identify a total of 5283 new mothers with depressive disorder. Multivariate logistic regression analyses were performed to measure the risk of giving birth to LBW, preterm, and SGA infants, relating to the number of prenatal care visits (10 or more, 8 to 9, and 7 or less) made by mothers with depressive disorder.Results: After adjusting for a woman's age, monthly income, urbanization level of place of residence, geographic location, marital status, substance abuse, arterial hypertension, diabetes, anemia, coronary heart disease, malpresentation, insufficient or excessive fetal growth, placenta or previa abruption, and infant's sex and parity, regression analyses revealed that mothers with a history of depressive disorder who received prenatal care 7 times or less were 4.21 (95% CI 3.34 to 5.32, P < 0.001), 5.37 (95% CI 4.33 to 6.67, P < 0.001), and 2.41 (95% CI 2.03 to 2.86, P < 0.001) times as likely to have LBW, preterm, and SGA babies, respectively, compared with mothers with depressive disorder who received prenatal care visits 10 times or more.Conclusions: Mothers with a history of depressive disorder who make fewer prenatal care visits were at an increased risk of LBW, SGA, and preterm birth, compared with women with a history of depressive disorder who made an adequate number of prenatal visits.