Maternal Mental and Physical Health Outcomes after Stillbirth and Infant Death

描述（由申请人提供）：本研究的目标是改善死产和婴儿死亡后丧亲母亲的心理健康护理和结果。在美国，每100名活产婴儿中，就有1-2名母亲因死产或婴儿死亡而怀孕，非洲裔美国母亲的风险尤其高。这些毁灭性的事件通常是创伤和改变生活的经历，使幸存的父母在随后的几年里处于长期悲伤和精神并发症的高风险之中。关于围产期损失对幸存母亲的长期心理健康影响知之甚少。此外，虽然超过70%的丧亲母亲在死产后一年内再次怀孕，但尚不清楚丧亲之痛如何影响随后的产前健康行为或损失后的妊娠结局。拟议的研究利用纵向数据分析和多年的邮件调查丧亲和非丧亲的母亲。研究A将胎儿或婴儿死亡后10年内的孕产妇和胎儿/婴儿健康数据集联系起来，以检查精神和身体健康障碍，随后几年的医疗保健费用和利用，以及新发孕产妇精神疾病的风险。研究B将对丧亲母亲和非丧亲对照进行纵向调查，以收集有关心理健康和随时间推移的治疗、身体健康、悲伤和丧亲、丧亲时的医院护理以及随后怀孕期间的生殖健康和健康行为的信息。 公共卫生相关性：虽然胎儿/婴儿死亡并不常见，但它仍然影响到100名母亲中的一名以上，并可能对失去亲人的母亲产生深刻影响，并可能影响其随后怀孕的结果。这项研究的结果可能有助于识别创伤性损失后患精神疾病风险最高的女性群体，衡量医院护理对孕产妇精神疾病发病率的影响，量化损失后几年孕产妇医疗保健的经济成本，并改善后续怀孕中的胎儿结局。

DESCRIPTION (provided by applicant): The goal of this research is to improve mental health care and outcomes of bereaved mothers after stillbirth and infant death. For every 100 live births in the United States, 1-2 mothers have a pregnancy complicated by a stillbirth or infant death, and African-American mothers are at particularly high risk. These devastating events are typically traumatic and life-altering experiences which put surviving parents at high risk for prolonged grief and psychiatric complications in the subsequent years. Little is known about the long-term mental health impact of perinatal loss on surviving mothers. In addition, while more than 70% of bereaved mothers are pregnant again within a year after a stillbirth, it is not known how mental health changes due to bereavement affect subsequent prenatal health behaviors or pregnancy outcomes after the loss. The proposed research utilizes both a longitudinal data analysis and a multi-year mail survey of bereaved and non-bereaved mothers. Study A links maternal and fetal/infant health datasets over 10 years following fetal or infant death to examine mental and physical health disorders, health care costs and utilization in subsequent years, and risk of new onset maternal mental illness. Study B will survey bereaved mothers and non-bereaved controls longitudinally to gather information about mental health and treatment over time, physical health, grief and bereavement, hospital care at the time of loss, and reproductive health and health behaviors during subsequent pregnancies. PUBLIC HEALTH RELEVANCE: While fetal/infant death is uncommon, it still affects more than one mother out of 100 and can profoundly impact bereaved mothers and may impact the outcomes of their subsequent pregnancies as well. Findings from this research may potentially help to identify populations of women at highest risk for mental illness after a traumatic loss, measure the impact of hospital care on maternal psychiatric morbidity, quantify the economic costs of maternal health care in the years following a loss, and improve fetal outcomes in subsequent pregnancies.