Lukasse Mirjam, Helbig Anne, Benth Jūratė Šaltytė, Eberhard-Gran Malin
Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Department of Health, Nutrition and Management, Oslo and Akershus university college of applied sciences, Oslo, Norway.
Norwegian Resource Centre for Women's Health, Oslo University Hospital, Oslo, Norway; Department of Obstetrics, Oslo University Hospital, Oslo, Norway.
PLoS One. 2014 Jul 7;9(7):e101682. doi: 10.1371/journal.pone.0101682. eCollection 2014.
OBJECTIVE(S): We sought to prospectively study the association between antenatal emotional distress and gestational length at birth as well as preterm birth.
We followed up 40,077 primiparous women in the Norwegian Mother and Child Cohort Study. Emotional distress was reported in a short form of the Hopkins Symptom Checklist-25 (SCL-5) at 17 and 30 weeks of gestation. Gestational length at birth, obtained from the Medical Birth Registry of Norway, was used as continuous (gestational length in days) and categorized (early preterm (22-31 weeks) and late preterm (32-36 weeks) versus term birth (≥ 37 weeks)) outcome, using linear and logistic regression analysis, respectively. Births were divided into spontaneous and provider-initiated.
Of all women, 7.4% reported emotional distress at 17 weeks, 6.0% at 30 weeks and 5.1% had a preterm birth. All measurements of emotional distress at 30 weeks were significantly associated with a reduction of gestational length, in days, for provider-initiated births at term. Emotional distress at 30 weeks showed a reduced duration of pregnancy at birth of 2.40 days for provider-initiated births at term. An increase in emotional distress from 17 to 30 weeks was associated with a reduction of gestational length at birth of 2.13 days for provider-initiated births at term. Sustained high emotional distress was associated with a reduction of gestational length at birth of 2.82 days for provider-initiated births. Emotional distress did not increase the risk of either early or late preterm birth.
Emotional distress at 30 weeks, an increase in emotional distress from 17 to 30 weeks and sustained high levels of emotional distress were associated with a reduction in gestational length in days for provider-initiated term birth. We found no significant association between emotional distress and the risk of preterm birth.
我们试图前瞻性地研究产前情绪困扰与出生时孕周以及早产之间的关联。
我们在挪威母婴队列研究中对40,077名初产妇进行了随访。在妊娠17周和30周时，通过霍普金斯症状清单-25（SCL-5）简表报告情绪困扰情况。从挪威医疗出生登记处获取的出生时孕周，分别用作连续变量（以天数表示的孕周）和分类变量（早期早产（22 - 31周）、晚期早产（32 - 36周）与足月产（≥37周））结局，分别采用线性回归和逻辑回归分析。分娩分为自然分娩和医源性分娩。
在所有女性中，7.4%在17周时报告有情绪困扰，6.0%在30周时报告有情绪困扰，5.1%发生了早产。对于医源性足月分娩，30周时所有情绪困扰测量指标均与孕周天数减少显著相关。30周时的情绪困扰表明，医源性足月分娩出生时的妊娠期缩短了2.40天。对于医源性足月分娩，从17周到30周情绪困扰增加与出生时孕周缩短2.13天相关。持续的高情绪困扰与医源性分娩出生时孕周缩短2.82天相关。情绪困扰并未增加早期或晚期早产的风险。
30周时的情绪困扰、从17周到30周情绪困扰增加以及持续的高情绪困扰水平与医源性足月分娩的孕周天数减少相关。我们发现情绪困扰与早产风险之间无显著关联。
