Unplanned pregnancy and subsequent psychological distress in partnered women: a cross-sectional study of the role of relationship quality and wider social support.
Unplanned pregnancy and subsequent psychological distress in partnered women: a cross-sectional study of the role of relationship quality and wider social support.
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合作妇女的计划外怀孕和随后的心理困扰：对关系质量和更广泛的社会支持的作用的横断面研究。
DOI：
10.1186/s12884-017-1223-x
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发表时间：
2017-01-26
影响因子：
3.1
通讯作者：
Carson C
中科院分区：
文献类型：
--
作者：
Barton K;Redshaw M;Quigley MA;Carson C
关于意外怀孕对女性福祉影响的研究往往集中于终止妊娠或单亲母亲的怀孕。意外怀孕在有伴侣的女性中很常见，但人们对意外怀孕与产后情感障碍（例如抑郁和焦虑）之间的关系知之甚少。人际关系质量差和缺乏社会支持被认为是心理困扰（PD）的危险因素。我们研究了有伴侣的女性中计划外生育与随后的 PD 之间的关系，但关于关系质量和社会支持的作用，证据很少。 12,462 名有伴侣的母亲的数据来自千禧队列研究的首次调查，该调查于产后 9 个月完成。妇女们报告了她们的孩子是否是计划好的，以及她们发现自己怀孕时的感受。怀孕意愿分为“计划内”、“计划外/快乐”、“计划外/矛盾”和“计划外/不快乐”。 PD 使用修改后的 9 项 Rutter 不适量表进行评估。社会支持是通过感知支持的综合得分以及朋友和家人的实际支持来衡量的。使用修改后的 Golombok-Rust 婚姻状况清单来评估关系质量。评估了怀孕意愿对 9 个月时 PD 几率的影响，并调整了潜在的混杂因素。所有分析均针对响应和设计效果进行加权。总共 32.8%（加权）(4343/12462) 的母亲报告了意外怀孕：23.3 wt% (3087) 的母亲在发现后感到高兴，3.5 wt% (475) 感到矛盾，6.0 wt% (781) 感到不高兴。与计划妊娠相比，计划外妊娠与 PD 的几率显着增加相关（OR 1.73 (95% CI: 1.53, 1.95)）。与报告积极情绪的女性相比，这一现象在怀孕早期报告消极或矛盾情绪的女性中更为明显（OR 分别为 2.72 (95%CI:2.17, 3.41) 和 2.56 (95%CI:1.95, 3.34)）。特别是对关系质量的调整，降低了意外怀孕后发生 PD 的几率（例如，与计划相比，计划外、不快乐组从 2.19 (95%C: 1.74, 2.74) 降至 1.63 (95% CI: 1.29, 2.07)。三分之一的有伴侣的母亲报告说，她们的怀孕是意外怀孕，但这一群体的研究尚未充分。母亲身份与产后 9 个月患 PD 的风险增加有关，特别是对于一开始感到不快乐或矛盾的女性。关系质量和社会支持的作用需要进一步研究，作为干预和改善产妇福祉的可能手段。
Research into the impact of unintended pregnancy on the wellbeing of women tends to focus on pregnancies ending in either termination or lone motherhood. Unintended pregnancy is common in partnered women, but little is known about the association between unintended pregnancy and postpartum affective disorders, such as depression and anxiety in this group. Poor relationship quality and lack of social support are considered risk factors for psychological distress (PD). We examined the association between unplanned motherhood and subsequent PD in partnered women, for whom evidence is sparse, accounting for the role of relationship quality and social support. Data for 12,462 partnered mothers were drawn from the first survey of Millennium Cohort Study, completed at 9 months postpartum. Women reported whether their baby was planned, and how they felt when they discovered that they were pregnant. Pregnancy intention is categorised as “planned”, “unplanned/happy”, “unplanned/ambivalent” and “unplanned/unhappy”. PD was assessed using the modified 9-item Rutter Malaise Inventory. Social support was measured by a composite score for perceived support, and a measure of actual support from friends and family. Relationship quality was assessed using a modified Golombok-Rust Inventory of Marital State. The effect of pregnancy intention on the odds of PD at 9 months was estimated, adjusting for potential confounding factors. All analyses were weighted for response and design effects. In total 32.8%(weighted) (4343/12462) of mothers reported an unplanned pregnancy: 23.3 wt% (3087) of mothers felt happy, 3.5 wt% (475) ambivalent, and 6.0 wt% (781) unhappy upon discovery. Unplanned pregnancy was associated with a significantly increased odds of PD compared to planned (OR 1.73 (95%CI: 1.53, 1.95)). This was more pronounced among women who reported negative or ambivalent feelings in early pregnancy (OR 2.72 (95%CI:2.17, 3.41) and 2.56 (95%CI:1.95, 3.34), respectively), than those who reported positive feelings (OR 1.39 (95%CI:1.21, 1.60)). Adjustment for relationship quality, in particular, reduced odds of PD after unplanned pregnancy (e.g. from 2.19 (95%C: 1.74, 2.74) to 1.63 (95% CI: 1.29, 2.07 in the unplanned, unhappy group compared to the planned). A third of partnered mothers reported that their pregnancy was unintended, yet this group is under-researched. Unplanned motherhood was associated with increased risk of PD at 9 months postpartum, particularly among women who felt unhappy or ambivalent at the start. The roles of relationship quality and social support require further investigation, as possible means to intervene and improve maternal wellbeing.