年龄、受孕方式、卫生服务利用和妊娠健康：澳大利亚女性的前瞻性队列研究。
Age, mode of conception, health service use and pregnancy health: a prospective cohort study of Australian women.
机构信息
School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
出版信息
BMC Pregnancy Childbirth. 2013 Apr 8;13:88. doi: 10.1186/1471-2393-13-88.
BACKGROUND
There is limited evidence about the ways in which maternal age and mode of conception interact with psychological, sociodemographic, health and health service factors in governing pregnancy health. The aim of this study was to establish in what ways maternal age and mode of conception are associated with, health behaviours, health service use and self-rated physical and mental health during pregnancy.
METHOD
A prospective cohort study was conducted in a collaboration between universities, infertility treatment services and public and private obstetric hospitals in Melbourne and Sydney, Australia,. Consecutive cohorts of nulliparous English-literate women at least 28 weeks pregnant who had conceived through ART (ARTC) or spontaneously (SC) in three age-groups: 20-30; 31-36 and at least 37 years were recruited. Data were obtained via structured individual telephone interviews and self-report postal questionnaires at recruitment and four months postpartum. Study-specific questions assessed: sociodemographic characteristics; reproductive health; health behaviours and health service use. Standardized instruments assessed physical health: SF 12 Physical Component Score (PCS) and mental health: SF12 Mental Component Score (MCS); State Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale. The main outcome measures were the SF 12 PCS, SF12 MCS scores and pregnancy-related hospital admissions.
RESULTS
Of 1179 eligible women 791 (67%) participated, 27 had fertility treatment without oocyte retrieval and were excluded and 592/764 (78%) completed all pregnancy assessments. When other factors were controlled speaking a language other than English, having private health insurance and multiple gestation were associated with worse physical health and having private health insurance and better physical health were associated with better mental health. Pregnancy-related hospital admissions were associated with worse physical health and multiple gestation.
CONCLUSIONS
Maternal age and mode of conception are not associated with pregnancy health and health service use when sociodemographic factors are considered.
背景
关于母亲年龄和受孕方式如何与心理、社会人口统计学、健康和健康服务因素相互作用以影响妊娠健康，目前相关证据有限。本研究旨在确定母亲年龄和受孕方式与妊娠期间的健康行为、健康服务使用以及自我评估的身体和心理健康之间的关联方式。
方法
本前瞻性队列研究由澳大利亚墨尔本和悉尼的大学、不孕治疗服务机构以及公立和私立产科医院合作开展。连续纳入至少 28 孕周、通过辅助生殖技术（ART）或自然受孕（SC）、且处于三个年龄组的初产妇：20-30 岁、31-36 岁和至少 37 岁。通过结构化个体电话访谈和招募时及产后四个月的邮寄问卷收集数据。研究特定问题评估了社会人口统计学特征、生殖健康、健康行为和健康服务使用情况。采用标准化工具评估了身体状况：SF-12 生理成分评分（PCS）和心理健康：SF-12 心理成分评分（MCS）；状态特质焦虑量表和爱丁堡产后抑郁量表。主要结局测量指标为 SF-12 PCS、SF12 MCS 评分和妊娠相关住院治疗情况。
结果
在 1179 名符合条件的女性中，有 791 名（67%）参与了研究，其中 27 名接受了无卵母细胞取出的生育治疗，被排除在外，592/764 名（78%）完成了所有妊娠评估。当控制其他因素（如讲英语以外的其他语言、拥有私人医疗保险和多胎妊娠）后，发现具有私人医疗保险和多胎妊娠与较差的身体状况相关，而拥有私人医疗保险与更好的心理健康状况相关。妊娠相关住院治疗与较差的身体状况和多胎妊娠相关。
结论
当考虑社会人口学因素时，母亲年龄和受孕方式与妊娠健康和健康服务使用无关。
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