van Ditzhuijzen Jenneke, Ten Have Margreet, de Graaf Ron, Lugtig Peter, van Nijnatten Carolus H C J, Vollebergh Wilma A M
Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands.
Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands.
J Psychiatr Res. 2017 Jan;84:200-206. doi: 10.1016/j.jpsychires.2016.10.006. Epub 2016 Oct 11.
Research in the field of mental health consequences of abortion is characterized by methodological limitations. We used exact matching on carefully selected confounders in a prospective cohort study of 325 women who had an abortion of an unwanted pregnancy and compared them 1-to-1 to controls who did not have this experience. Outcome measures were incidence and recurrence of common DSM-IV mental disorders (mood, anxiety, substance use disorders, and the aggregate measure 'any mental disorder') as measured with the Composite International Diagnostic Interview (CIDI) version 3.0, in the 2.5-3 years after the abortion. Although non-matched data suggested otherwise, women in the abortion group did not show significantly higher odds for incidence of 'any mental disorder', or mood, anxiety and substance use disorders, compared to matched controls who were similar in background variables but did not have an this experience. Having an abortion did not increase the odds for recurrence of the three disorder categories, but for any mental disorder the higher odds in the abortion group remained significant after matching. It is unlikely that termination of an unwanted pregnancy increases the risk on incidence of common mental disorders in women without a psychiatric history. However, it might increase the risk of recurrence among women with a history of mental disorders.
堕胎对心理健康影响领域的研究存在方法学上的局限性。在一项针对325名因意外怀孕而堕胎的女性的前瞻性队列研究中，我们在精心挑选的混杂因素上进行了精确匹配，并将她们与没有这种经历的对照组进行一对一比较。结局指标是使用综合国际诊断访谈（CIDI）3.0版测量的常见DSM-IV精神障碍（情绪、焦虑、物质使用障碍以及综合指标“任何精神障碍”）在堕胎后2.5至3年的发病率和复发率。尽管未匹配的数据显示情况并非如此，但与背景变量相似但没有这种经历的匹配对照组相比，堕胎组女性在“任何精神障碍”、情绪、焦虑和物质使用障碍的发病率方面并未显示出显著更高的几率。堕胎并未增加这三类障碍复发的几率，但对于任何精神障碍，堕胎组在匹配后较高的几率仍然显著。意外怀孕的终止不太可能增加无精神病史女性患常见精神障碍的风险。然而，它可能会增加有精神障碍病史女性复发的风险。
