Key Centre for Women's Health in Society, Melbourne School of Population Health, University of Melbourne, Melbourne, VIC 3010, Australia.
Hum Reprod. 2009 Nov;24(11):2801-9. doi: 10.1093/humrep/dep282. Epub 2009 Aug 6.
Higher rates of admission to residential early parenting services (REPSs) after assisted conception compared with spontaneous conception have been reported. The aim of this study was to characterize early post-partum psychological functioning and the rate of, and risks factors for, admission to REPSs in women conceiving with assisted reproductive technology (ART) in Australia.
A consecutive cohort of women who had conceived through ART was recruited systematically in early pregnancy. At 3 months post-partum, participants completed postal questionnaires which included a new measure of the degree of difficulty involved in conceiving, the Burden of Infertility and Treatment (BIT) scale.
Of 166 women who participated, 8% had already been admitted to a REPS within 3 months, which is a higher rate compared with other women in the first 12 months (5%). Compared with community samples of new mothers, there was no difference in rate of depression. A higher proportion reported dysregulated infant behaviours (P < 0.0001) and a smaller proportion was breast feeding exclusively (P < 0.0001). Greater difficulty conceiving (higher BIT score) was associated with lower maternal confidence.
Clinical care of the increasing group of women who conceive with ART should include explicit assessment of early post-partum psychological functioning and early intervention if difficulties in managing infant behaviour are reported.
与自然受孕相比,辅助受孕后的女性更有可能被收治到住院早期育儿服务(REPS)中。本研究旨在描述通过澳大利亚辅助生殖技术(ART)受孕的女性产后早期的心理功能以及收治到 REPS 的比例,以及相关的风险因素。
本研究采用系统招募的方法,招募了一批在早期妊娠期间通过 ART 受孕的连续队列女性。产后 3 个月,参与者通过邮寄问卷的方式完成了调查,问卷包括一项新的受孕困难程度衡量指标——不孕和治疗负担(BIT)量表。
在 166 名参与研究的女性中,有 8%的女性在产后 3 个月内已经被收治到 REPS,这一比例高于其他女性在前 12 个月内的收治比例(5%)。与新妈妈的社区样本相比,该研究中抑郁的发生率没有差异。报告婴儿行为失调的比例更高(P < 0.0001),纯母乳喂养的比例更小(P < 0.0001)。受孕困难程度越大(BIT 得分越高),产妇的自信心越低。
对于越来越多通过 ART 受孕的女性,临床护理应包括对产后早期心理功能的明确评估,如果报告存在婴儿行为管理困难,应进行早期干预。