Karjane Nicole W, Stovall Dale W, Berger Nathan G, Svikis Dace S
Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia 23298-0034, USA.
J Womens Health (Larchmt). 2008 Dec;17(10):1623-7. doi: 10.1089/jwh.2007.0651.
To determine if a history of infertility is associated with alcohol abuse risk factors, depression, and other psychiatric disorders.
Pregnant women awaiting their first prenatal visit completed a questionnaire and subsequently participated in an interview consisting of the Structured Clinical Interview for DSM-IIIR and the Family Alcohol and Drug Survey. The data obtained from women with a history of infertility were compared with the data from women without prior infertility.
Eighty-nine pregnant women participated in the study, 27 with prior infertility and 62 without. Subjects were demographically similar, except that women with a history of infertility were slightly older than controls (34.7 vs. 31.1 years, p < 0.001). Pregnant women with a history of infertility reported needing significantly more drinks to get high, (3.3 vs. 2.7, p = 0.04) and were more likely to have clinically elevated tolerance, annoyance, cut-down, and eye-opener (T-ACE) alcohol tolerance scores (83.3% vs. 52.3%, p < 0.01) than women without such history. Major depression (lifetime) was diagnosed in 69.2% of infertility subjects compared with 30% of controls (p < 0.05). Lifetime simple phobia (23.1% vs. 10%, p < 0.01), generalized anxiety disorder (23.1% vs. 3%, p < 0.01), panic disorder (15.4% vs. 0%, p < 0.05), and bulimia (7.7% vs. 0%, p < 0.05) were also more common in women with a history of infertility compared with controls.
Pregnant women with a history of infertility are at increased risk for alcohol abuse and are more likely to suffer from other psychiatric disorders than women without such history. Special attention to these issues is warranted when caring for pregnant women who were previously infertile.
确定不孕史是否与酒精滥用风险因素、抑郁症及其他精神障碍相关。
等待首次产前检查的孕妇完成一份问卷,随后参加由《精神疾病诊断与统计手册第三版修订本》结构化临床访谈和家庭酒精与药物调查组成的访谈。将有不孕史女性的数据与无不孕史女性的数据进行比较。
89名孕妇参与了研究,其中27名有不孕史,62名无不孕史。除有不孕史的女性比对照组稍年长(34.7岁对31.1岁,p<0.001)外,两组受试者在人口统计学特征上相似。有不孕史的孕妇报告称达到兴奋状态需要饮用更多的酒(3.3杯对2.7杯,p = 0.04),且与无此病史的女性相比,更有可能出现临床上耐受性、烦恼、减少饮酒量及晨起饮酒(T-ACE)酒精耐受评分升高(83.3%对52.3%,p<0.01)。69.2%有不孕史的受试者被诊断为重度抑郁症(终生患病),而对照组为30%(p<0.05)。与对照组相比,有不孕史的女性终生单纯恐惧症(23.1%对10%,p<0.01)、广泛性焦虑障碍(23.1%对3%,p<0.01)、惊恐障碍(15.4%对0%,p<0.05)及神经性贪食症(7.7%对0%,p<0.05)也更为常见。
有不孕史的孕妇酒精滥用风险增加,且比无此病史的女性更易患其他精神障碍。在照顾既往不孕的孕妇时,有必要特别关注这些问题。