Chojenta Catherine, Harris Sheree, Reilly Nicole, Forder Peta, Austin Marie-Paule, Loxton Deborah
Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW, Australia.
Perinatal and Women's Mental Health Unit, St John of God Health Care and University of New South Wales, Sydney, NSW, Australia.
PLoS One. 2014 Apr 14;9(4):e95038. doi: 10.1371/journal.pone.0095038. eCollection 2014.
While grief, emotional distress and other mental health conditions have been associated with pregnancy loss, less is known about the mental health impact of these events during subsequent pregnancies and births. This paper examined the impact of any type of pregnancy loss on mental health in a subsequent pregnancy and postpartum. Data were obtained from a sub-sample (N = 584) of the 1973-78 cohort of the Australian Longitudinal Study on Women's Health, a prospective cohort study that has been collecting data since 1996. Pregnancy loss was defined as miscarriage, termination due to medical reasons, ectopic pregnancy and stillbirth. Mental health outcomes included depression, anxiety, stress or distress, sadness or low mood, excessive worry, lack of enjoyment, and feelings of guilt. Demographic factors and mental health history were controlled for in the analysis. Women with a previous pregnancy loss were more likely to experience sadness or low mood (AOR = 1.75, 95% CI: 1.11 to 2.76, p = 0.0162), and excessive worry (AOR = 2.01, 95% CI: 1.24 to 3.24, p = 0.0043) during a subsequent pregnancy, but not during the postpartum phase following a subsequent birth. These results indicate that while women who have experienced a pregnancy loss are a more vulnerable population during a subsequent pregnancy, these deficits are not evident in the postpartum.
虽然悲伤、情绪困扰和其他心理健康状况与妊娠丢失有关,但对于这些事件在随后的妊娠和分娩期间对心理健康的影响,人们了解得较少。本文研究了任何类型的妊娠丢失对随后妊娠和产后心理健康的影响。数据来自澳大利亚妇女健康纵向研究1973 - 1978队列的一个子样本(N = 584),这是一项前瞻性队列研究,自1996年以来一直在收集数据。妊娠丢失定义为流产、因医学原因终止妊娠、异位妊娠和死产。心理健康结果包括抑郁、焦虑、压力或困扰、悲伤或情绪低落、过度担忧、缺乏愉悦感和内疚感。分析中控制了人口统计学因素和心理健康史。有过妊娠丢失史的女性在随后妊娠期间更有可能经历悲伤或情绪低落(调整后的比值比[AOR] = 1.75,95%置信区间[CI]:1.11至2.76,p = 0.0162),以及过度担忧(AOR = 2.01,95% CI:1.24至3.24,p = 0.0043),但在随后分娩后的产后阶段则不然。这些结果表明,虽然经历过妊娠丢失的女性在随后妊娠期间是更脆弱的人群,但这些不足在产后并不明显。