Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, 610 North Walnut Street, Office 503, Madison, WI 53726, USA.
Matern Child Health J. 2012 Oct;16(7):1525-41. doi: 10.1007/s10995-011-0916-4.
Pregnancy complications and poor birth outcomes can affect the survival and long-term health of children. The preconception period represents an opportunity to intervene and improve outcomes; however little is known about women's mental health prior to pregnancy as a predictor of such outcomes. We sought to determine if and to what extent women's preconception mental health status impacted subsequent pregnancy complications, non-live birth, and birth weight using a nationally representative, population-based sample. We used pooled 1996-2006 data from the nationally-representative Medical Expenditure Panel Survey (MEPS). Poor preconception mental health was defined as women's global mental health rating of "fair" or "poor" before conception. Logistic regression was used to assess the association between preconception mental health and pregnancy complications, non-live birth, and having a low birth weight baby within the follow up period. Poor preconception mental health was associated with increased odds of experiencing any pregnancy complication (AOR 1.40, 95% CI: 1.02-1.92), having a non-live birth (AOR 1.48, 95% CI: 0.96-2.27), and having a low birth weight baby (AOR 1.99, 95% CI: 1.00-3.98), all controlling for maternal age, race/ethnicity, marital status, education, health insurance status, income, and number of children in the household. Significant racial and ethnic disparities exist for pregnancy complications and non-live births, but not for low birth weight. Women's preconception mental health is a modifiable risk factor that stands to reduce the incidence of adverse pregnancy complications and birth outcomes.
妊娠并发症和不良出生结局会影响儿童的生存和长期健康。孕前阶段是进行干预和改善结局的机会；然而，人们对孕妇孕前的心理健康状况作为这些结局的预测因素知之甚少。我们试图确定女性的孕前心理健康状况是否以及在何种程度上影响随后的妊娠并发症、非活产和出生体重，使用的是具有全国代表性的基于人群的样本。我们使用了具有全国代表性的医疗支出面板调查（MEPS）1996-2006 年期间的数据进行汇总。孕前心理健康状况不佳定义为女性在受孕前的整体心理健康评分“一般”或“差”。使用逻辑回归评估孕前心理健康状况与妊娠并发症、非活产和在随访期间出生体重低的婴儿之间的关联。孕前心理健康状况不佳与经历任何妊娠并发症的几率增加相关（OR 1.40，95%CI：1.02-1.92）、非活产的几率增加（OR 1.48，95%CI：0.96-2.27）和出生体重低的婴儿的几率增加（OR 1.99，95%CI：1.00-3.98），所有这些都控制了母亲的年龄、种族/族裔、婚姻状况、教育程度、保险状况、收入和家庭中的孩子数量。妊娠并发症和非活产存在显著的种族和族裔差异，但出生体重低则没有。女性的孕前心理健康是一个可改变的风险因素，可以降低不良妊娠并发症和出生结局的发生率。
