宫内胎儿死亡对生活质量和抑郁的长期影响：病例对照研究。
Long-term impact of intrauterine fetal death on quality of life and depression: a case-control study.
机构信息
Department of Haematology, Oslo University Hospital, Ulleval, Oslo, Norway.
出版信息
BMC Pregnancy Childbirth. 2012 Jun 7;12:43. doi: 10.1186/1471-2393-12-43.
BACKGROUND
Intrauterine fetal death (IUFD) is a serious incidence that has been shown to impact mothers' psychological well-being in the short-term. Long-term quality of life (QOL) and depression after IUFD is not known. This study aimed to determine the association between intrauterine fetal death and long-term QOL, well-being, and depression.
METHODS
Analyses were performed on collected data among 106 women with a history of intrauterine fetal death (IUFD) and 262 women with live births, 5-18 years after the event. Univariable and multivariable linear and logistic regression models were used to quantify the association between previous fetal death and long-term QOL, well-being and depression. QOL was assessed using the QOL Index (QLI), symptoms of depression using the Center for Epidemiological Studies Depression Scale (CES-D), and subjective well-being using the General Health Questionnaire 20 (GHQ-20).
RESULTS
More of the cases had characteristics associated with lower socioeconomic status and did not rate their health as good as did the controls. The QLI health and functioning subscale score was slightly but significantly lower in the cases than in the controls (22.3. vs 23.5, P = .023). The CES-D depressed affect subscale score (2.0 vs 1.0, P = 0.004) and the CES-D global score (7.4 vs 5.0, P = .017) were higher in the cases. Subjective well-being did not differ between groups (20.6 vs 19.4, P = .094). After adjusting for demographic and health-related variables, IUFD was not associated with global QOL (P = .674), subjective well-being (P = .700), or global depression score (adjusted odds ratio = 0.77, 95% confidence interval 0.37-1.57).
CONCLUSIONS
Women with previous IUFD, of which the majority have received short-term interventions, share the same level of long-term QOL, well-being and global depression as women with live births only, when adjusted for possible confounders.
TRIAL REGISTRATION
The study was registered at http://www.clinicaltrials.gov, with registration number NCT 00856076.
背景
宫内胎儿死亡（IUFD）是一种严重的情况，已被证明会对母亲的短期心理健康产生影响。IUFD 后的长期生活质量（QOL）和抑郁情况尚不清楚。本研究旨在确定宫内胎儿死亡与长期 QOL、幸福感和抑郁之间的关系。
方法
对 106 名有宫内胎儿死亡史（IUFD）的妇女和 262 名有活产史的妇女的收集数据进行分析，这些妇女在事件发生后 5-18 年接受了调查。使用单变量和多变量线性和逻辑回归模型来量化先前胎儿死亡与长期 QOL、幸福感和抑郁之间的关系。使用生活质量指数（QLI）评估 QOL，使用流行病学研究抑郁量表（CES-D）评估抑郁症状，使用 20 项一般健康问卷（GHQ-20）评估主观幸福感。
结果
更多的病例具有与较低社会经济地位相关的特征，并且她们对自己的健康状况的评价不如对照组。病例组的 QLI 健康和功能子量表评分略低于对照组（22.3 与 23.5，P =.023）。病例组的 CES-D 抑郁情绪子量表评分（2.0 与 1.0，P = 0.004）和 CES-D 总分（7.4 与 5.0，P =.017）较高。两组的主观幸福感无差异（20.6 与 19.4，P =.094）。在调整人口统计学和健康相关变量后，IUFD 与总体 QOL 无关（P =.674），与主观幸福感无关（P =.700），也与全球抑郁评分无关（调整后的比值比= 0.77，95%置信区间 0.37-1.57）。
结论
大多数接受过短期干预的 IUFD 妇女，与有活产史的妇女一样，在调整可能的混杂因素后，具有相同的长期 QOL、幸福感和全球抑郁水平。
试验注册
该研究在 http://www.clinicaltrials.gov 上注册，注册号为 NCT 00856076。
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