Munk-Olsen Trine, Bech Bodil Hammer, Vestergaard Mogens, Li Jiong, Olsen Jørn, Laursen Thomas Munk
iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, National Center for Register-Based Research, Aarhus University, Aarhus V, Denmark.
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark.
BMJ Open. 2014 Jun 6;4(6):e005187. doi: 10.1136/bmjopen-2014-005187.
Women have increased risks of severe mental disorders after childbirth and death of a child, but it remains unclear whether this association also applies to fetal loss and, if so, to which extent. We studied the risk of any inpatient or outpatient psychiatric treatment during the time period from 12 months before to 12 months after fetal death.
Cohort study using Danish population-based registers.
Denmark.
A total of 1 112 831 women born in Denmark from 1960 to 1995 were included. In total, 87 687cases of fetal death (International Classification of Disease-10 codes for spontaneous abortion or stillbirth) were recorded between 1996 and 2010.
The main outcome measures were incidence rate ratios (risk of first psychiatric inpatient or outpatient treatment).
A total of 1379 women had at least one psychiatric episode during follow-up from the year before fetal death to the year after. Within the first few months after the loss, women had an increased risk of psychiatric contact, IRR: 1.51 (95% CI 1.15 to 1.99). In comparison, no increased risk of psychiatric contact was found for the period before fetal death. The risk of experiencing a psychiatric episode was highest for women with a loss occurring after 20 weeks of gestation (12 month probability: 1.95%, 95% CI 1.50 to 2.39).
Fetal death was associated with a transient increased risk of experiencing a first-time episode of a psychiatric disorder, primarily adjustment disorders. The risk of psychiatric episodes tended to increase with increasing gestational age at the time of the loss.
产后及子女死亡后女性患严重精神障碍的风险会增加，但尚不清楚这种关联是否也适用于胎儿丢失，若适用，程度如何。我们研究了胎儿死亡前12个月至死亡后12个月期间进行任何住院或门诊精神科治疗的风险。
基于丹麦人群登记册的队列研究。
丹麦。
纳入了1960年至1995年在丹麦出生的总共1112831名女性。1996年至2010年期间共记录了87687例胎儿死亡病例（国际疾病分类-10中自然流产或死产的编码）。
主要结局指标为发病率比（首次精神科住院或门诊治疗的风险）。
从胎儿死亡前一年到死亡后一年的随访期间，共有1379名女性至少有一次精神科发作。在胎儿丢失后的头几个月内，女性进行精神科就诊的风险增加，发病率比：1.51（95%置信区间1.15至1.99）。相比之下，在胎儿死亡前未发现精神科就诊风险增加。对于妊娠20周后发生胎儿丢失的女性，经历精神科发作的风险最高（12个月概率：1.95%，95%置信区间1.50至2.39）。
胎儿死亡与首次发生精神障碍发作的短暂风险增加相关，主要是适应障碍。精神科发作的风险往往随着丢失时胎龄的增加而增加。
