Fairbrother Nichole, Young Allan H, Zhang Areiyu, Janssen Patricia, Antony Martin M
Department of Psychiatry, Island Medical Program, University of British Columbia, Queen Alexandra Centre for Children's Health, 2400 Arbutus Road, Victoria, BC, V8N 1V7, Canada.
Institute of Psychiatry, Psychology and Neurosciences, King's College London, Strand, London, England, WC2R 2LS, UK.
Arch Womens Ment Health. 2017 Apr;20(2):311-319. doi: 10.1007/s00737-016-0704-7. Epub 2016 Dec 28.
Over 20% of pregnancies involve medical difficulties that pose some threat to the health and well-being of the mother, her developing infant, or both. We report on the first comparison of the prevalence and incidence of maternal anxiety disorders (AD) in pregnancy and the postpartum, across levels of medical risk in pregnancy. Pregnant women (N = 310) completed postnatal screening measures for anxiety. Women who scored at or above cutoff on one or more of the screening measures were administered a diagnostic interview (n = 115) for AD. Pregnancies were classified into low, moderate, or high risk based on self-report and contact with high-risk maternity clinics. The incidence of AD in pregnancy was higher among women classified as experiencing a medically moderate or high-risk pregnancy, compared with women classified as experiencing a medically low-risk pregnancy. Across risk groups, there were no differences in AD prevalence or in the incidence of AD in the postpartum. Demographic characteristics and parity did not contribute meaningfully to outcomes. Pregnancies characterized by medical risks are associated with an increased likelihood of new onset AD. Women experiencing medically complex pregnancies should be screened for anxiety and offered appropriate treatment.
超过20%的妊娠存在医学难题,对母亲、其发育中的胎儿或两者的健康和福祉构成某种威胁。我们报告了首次对孕期和产后母亲焦虑症(AD)的患病率和发病率进行的比较,涵盖了孕期不同医学风险水平。310名孕妇完成了焦虑症的产后筛查措施。在一项或多项筛查措施中得分达到或高于临界值的女性接受了AD诊断访谈(n = 115)。根据自我报告以及与高危产科诊所的接触情况,将妊娠分为低风险、中度风险或高风险。与被归类为医学低风险妊娠的女性相比,被归类为医学中度或高风险妊娠的女性孕期AD发病率更高。在所有风险组中,产后AD患病率或发病率没有差异。人口统计学特征和产次对结果没有显著影响。具有医学风险特征的妊娠与新发AD的可能性增加有关。经历医学复杂妊娠的女性应接受焦虑症筛查并获得适当治疗。