Munk-Olsen Trine, Laursen Thomas Munk, Pedersen Carsten Bøcker, Mors Ole, Mortensen Preben Bo
National Centre for Register-Based Research, University of Aarhus, Aarhus, Denmark.
JAMA. 2006 Dec 6;296(21):2582-9. doi: 10.1001/jama.296.21.2582.
Studies on postpartum mental disorders among mothers have primarily focused on either depression or psychoses and have generally not included the broader spectrum of mental disorders. A few studies have found that some men have symptoms of depression after becoming fathers, but these studies have not documented whether this exceeds the morbidity among men in general.
To estimate the risk of postpartum mental disorders necessitating hospital admission or outpatient contact for mothers as well as fathers during a 1-year postnatal follow-up period after birth of first live-born child and to investigate whether parents in general differ from nonparents in the risk of admission with a mental disorder and how this difference varies with age.
DESIGN, SETTING, AND PATIENTS: Register-based cohort formed by linking information from Danish health and civil service registers. A total of 2,357,942 Danish-born persons were followed up from their 15th birthday or January 1, 1973, whichever came later, until date of onset of the disorder in question, date of death, date of emigration from Denmark, or July 1, 2005, whichever came first. From 1973 to 2005, a total of 630,373 women and 547,431 men became parents for the first time, and during the first year after childbirth, these parents contributed 1,115,639 person-years at risk.
First-time psychiatric hospital admission or outpatient contact 0 to 12 months after becoming a parent.
A total of 1171 mothers and 658 fathers were admitted with a mental disorder to a psychiatric hospital during the first 12 months after parenthood, and the corresponding prevalence of severe mental disorders through the first 3 months after childbirth was 1.03 per 1000 births for mothers and 0.37 per 1000 births for fathers. Compared with women who had given birth 11 to 12 months prior, primiparous women had an increased risk of incident hospital admission with any mental disorder through the first 3 months after childbirth, with the highest risk 10 to 19 days postpartum (relative risk [RR], 7.31; 95% confidence interval [CI], 5.44-9.81). Among mothers, risk was also increased for psychiatric outpatient contacts through the first 3 months after childbirth, also with the highest risk occurring 10 to 19 days postpartum (RR, 2.67; 95% CI, 1.99-3.59). Unlike motherhood, fatherhood was not associated with any increased risk of hospital admission or outpatient contact.
In Denmark, the risk of postpartum mental disorders among primiparous mothers is increased for several months after childbirth, but among fathers there is no excess of severe mental disorders necessitating admission or outpatient contacts.
关于母亲产后精神障碍的研究主要集中在抑郁症或精神病方面，通常未涵盖更广泛的精神障碍范围。一些研究发现，一些男性在成为父亲后出现抑郁症状，但这些研究并未记录这种情况是否超过一般男性的发病率。
估计首次生育活产儿后1年产后随访期间母亲和父亲因产后精神障碍需要住院或门诊治疗的风险，并调查父母总体上在因精神障碍住院风险方面与非父母是否存在差异，以及这种差异如何随年龄变化。
设计、地点和患者：通过链接丹麦健康和公务员登记册中的信息形成基于登记的队列。对总共2357942名丹麦出生的人进行随访，从他们15岁生日或1973年1月1日（以较晚者为准）开始，直至出现相关疾病、死亡、从丹麦移民或2005年7月1日（以最早者为准）。1973年至2005年，共有630373名女性和547431名男性首次成为父母，在产后第一年，这些父母贡献了1115639人年的风险暴露时间。
成为父母后0至12个月首次因精神疾病住院或门诊治疗。
在成为父母后的前12个月内，共有1171名母亲和658名父亲因精神障碍入住精神病院，产后前3个月严重精神障碍的相应患病率母亲为每1000例分娩1.03例，父亲为每1000例分娩0.37例。与在11至12个月前分娩的女性相比，初产妇在产后前3个月因任何精神障碍住院的风险增加，产后10至19天风险最高（相对风险[RR]，7.31；95%置信区间[CI]，5.44 - 9.81）。在母亲中，产后前3个月精神科门诊就诊风险也增加，同样在产后10至19天风险最高（RR，2.67；95%CI，1.99 - 3.59）。与母亲身份不同，父亲身份与住院或门诊就诊风险增加无关。
在丹麦，初产妇产后几个月内产后精神障碍风险增加，但父亲中不存在需要住院或门诊治疗的严重精神障碍过多的情况。
