Pregnancy loss and anxiety and depression during subsequent pregnancies: data from the C-ABC study
Pregnancy loss and anxiety and depression during subsequent pregnancies: data from the C-ABC study
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妊娠失败以及随后怀孕期间的焦虑和抑郁：来自 C-ABC 研究的数据。
DOI：
10.1016/j.ejogrb.2012.09.024
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发表时间：
2013-01-01
影响因子：
2.6
通讯作者：
Xu, Rong
中科院分区：
文献类型：
--
作者：
Gong, Xiangjun;Hao, Jiahu;Xu, Rong
目的：已有研究表明，妊娠丢失可能会影响再次妊娠妇女的心理健康。因此，中国安徽省出生缺陷和儿童发育队列研究旨在调查丢失妊娠对后续妊娠焦虑和抑郁的影响。研究设计：总共20,308名孕妇提供书面知情同意并完成研究问卷。采用焦虑自评量表和流行病学研究中心抑郁自评量表对孕妇的焦虑、抑郁情绪进行评定。结果：20308例孕妇中，1495例(7.36%)有流产史，7686例(37.85%)有人工流产史。二元Logistic回归模型发现，根据第一次产前检查的时间进行分层分析后，有流产史的孕妇在怀孕早期患焦虑和抑郁的风险显著高于初产妇(p<；0.05)。与没有流产史的孕妇相比，有流产史和口译间隔少于6个月的妇女在怀孕前三个月出现焦虑症状(P<；0.05)和抑郁症状(P<；0.05)的风险增加。口译间隔7-12个月的女性患抑郁症的风险是没有流产史的女性的2.511倍。在调整了母亲年龄、母亲教育程度、家庭收入、居住地和孕前体重指数后，这些结果没有改变。结论：有流产史的妇女在下一次怀孕期间经历了明显的焦虑和抑郁。较短的口译间隔和怀孕前三个月是不良心理健康的危险因素。(C)2012爱思唯尔爱尔兰有限公司。保留所有权利。
Objective: Previous studies have shown that pregnancy loss may affect the mental health of women in subsequent pregnancies. The China Anhui Birth Defects and Child Development cohort study therefore aimed to investigate the influence of pregnancy loss on anxiety and depression in subsequent pregnancies.Study design: In total, 20,308 pregnant women provided written informed consent and completed the study questionnaire. The Self-rating Anxiety Scale and Center for Epidemiologic Studies-Depression Scale were used to evaluate anxiety and depression in pregnant women. Pearson's chi(2) test and binary logistic regression were used for statistical analyses.Results: Of 20,308 pregnant women, 1495 (7.36%) had a history of miscarriage and 7686 (37.85%) had a history of induced abortion. The binary logistic regression model found that pregnant women with a history of miscarriage had a significantly higher risk of anxiety and depression in the first trimester than primigravidae after stratified analysis according to the timing of the first prenatal visit (p < 0.05). Compared with pregnant women with no history of miscarriage, women who had a history of miscarriage and an interpregnancy interval of less than 6 months had increased risk of anxiety symptoms (p < 0.05) and depression symptoms (p < 0.05) during the first trimester. Women with an interpregnancy interval of 7-12 months had a 2.511-fold higher risk of depression (p < 0.05) than women with no history of miscarriage. These findings were not changed after adjustment for maternal age, maternal education, family income, place of residence and pre-pregnancy body mass index.Conclusions: Women with a history of miscarriage experienced significant anxiety and depression during their next pregnancy. A short interpregnancy interval and the first trimester are risk factors for adverse mental health. (C) 2012 Elsevier Ireland Ltd. All rights reserved.