Vilska S, Unkila-Kallio L, Punamäki R-L, Poikkeus P, Repokari L, Sinkkonen J, Tiitinen A, Tulppala M
Infertility Clinic, The Family Federation of Finland, PO Box 849, 00101 Helsinki, Finland.
Hum Reprod. 2009 Feb;24(2):367-77. doi: 10.1093/humrep/den427. Epub 2008 Nov 29.
Although twin deliveries after assisted reproduction treatment (ART) are common, the mental health of the parents has scarcely been addressed. Therefore, we evaluated the psychological well-being of ART and spontaneously conceiving parents of twins and singletons. Furthermore, the impact of parity and children's health-related factors on mental health was evaluated.
We conducted a prospective longitudinal questionnaire study among ART parents of 91 pairs of twins and of 367 singletons and on control parents of 20 pairs of twins and of 379 singletons in the 2nd trimester of pregnancy (T1), and when the children were 2 months (T2) and 1-year old (T3). Symptoms of depression and anxiety, sleeping difficulties and social dysfunction were addressed via a questionnaire. The effects of parity and child-related factors were assessed at T2.
At T1, ART mothers of twins showed fewer symptoms of depression than control mothers of twins (P < 0.05). At T2, both ART and control mothers of twins had more symptoms of depression and anxiety than all mothers of singletons (F = 5.20, P < 0.05 and F = 3.93, P < 0.05, respectively). At T3, both ART and control mothers of twins continued to report more symptoms of depression than the mothers of singletons (F = 10.01, P < 0.01), but a difference in anxiety symptoms was seen only in the control group. All fathers had similar mental health at T1. At T2, ART and control fathers of twins reported more symptoms of depression (F = 4.15, P < 0.05) and social dysfunction than fathers of singletons. At T3, both ART and control fathers of twins had more symptoms of depression (F = 4.29, P < 0.05) and anxiety (F = 5.40, P < 0.05) than fathers of singletons. Control fathers of twins had more sleeping difficulties than fathers of singletons (F = 6.66, P < 0.01). Parity did not differently affect parental mental health at T2 in the study groups. Prematurity did not affect maternal mental health, but it had a negative impact on control fathers' social dysfunction (F = 3.34, P < 0.05).
Twin parenthood, but not ART, has a negative impact on the mental health of mothers and fathers during the transition to parenthood. ART parents' mental health was not affected by parity or children's health-related factors.
尽管辅助生殖治疗(ART)后双胞胎分娩很常见,但父母的心理健康几乎未得到关注。因此,我们评估了ART受孕及自然受孕的双胞胎和单胎父母的心理健康状况。此外,还评估了胎次和儿童健康相关因素对心理健康的影响。
我们对91对双胞胎和367名单胎ART受孕父母以及20对双胞胎和379名单胎对照父母进行了一项前瞻性纵向问卷调查研究,调查时间分别为妊娠中期(T1)、孩子2个月大时(T2)和1岁时(T3)。通过问卷了解抑郁、焦虑症状、睡眠困难和社交功能障碍情况。在T2时评估胎次和与孩子相关因素的影响。
在T1时,ART受孕的双胞胎母亲的抑郁症状少于对照双胞胎母亲(P<0.05)。在T2时,ART受孕和对照双胞胎母亲的抑郁和焦虑症状均多于所有单胎母亲(F=5.20,P<0.05;F=3.93,P<0.05)。在T3时,ART受孕和对照双胞胎母亲的抑郁症状仍多于单胎母亲(F=10.01,P<0.01),但焦虑症状的差异仅在对照组中可见。所有父亲在T1时心理健康状况相似。在T2时,ART受孕和对照双胞胎父亲的抑郁症状(F=4.15,P<0.05)和社交功能障碍多于单胎父亲。在T3时,ART受孕和对照双胞胎父亲的抑郁症状(F=4.29,P<0.05)和焦虑症状(F=5.40,P<0.05)均多于单胎父亲。对照双胞胎父亲的睡眠困难多于单胎父亲(F=6.66,P<0.01)。在研究组中,胎次在T(2)时对父母心理健康的影响无差异。早产不影响母亲心理健康,但对对照父亲的社交功能有负面影响(F=3.34,P<0.05)。
生育双胞胎,而非ART,在向父母角色转变过程中对母亲和父亲的心理健康有负面影响。ART受孕父母的心理健康不受胎次或儿童健康相关因素的影响。