Staneva Aleksandra A, Morawska Alina, Bogossian Fiona, Wittkowski Anja
a The School of Psychology , The University of Queensland , Brisbane , Queensland , Australia.
b The School of Nursing, Midwifery and Social Work , The University of Queensland , Brisbane , Queensland , Australia.
Women Health. 2018 Jan;58(1):92-111. doi: 10.1080/03630242.2017.1282395. Epub 2017 Jan 17.
Maternal psychological distress during pregnancy is a potential risk factor for various birth complications. This study aimed to explore psychological factors associated with adverse birth outcomes. Symptoms of psychological distress, individual characteristics, and medical complications were assessed at two time points antenatally in 285 women from Australia and New Zealand; birth outcomes were assessed postpartum, between January 2014 and September 2015. Hierarchical multiple regression analyses were conducted to examine the relation of psychological distress to adverse birth outcomes. Medical complications during pregnancy, such as serious infections, placental problems and preeclampsia, and antenatal cannabis use, were the factors most strongly associated with adverse birth outcomes, accounting for 22 percent of the total variance (p < .001). Symptoms of depression and/or anxiety, low social support, and low sense of coherence were not associated with birth complications. In unadjusted analyses, self-reported diagnosis of anxiety disorder during pregnancy and an orientation toward a Regulator mothering style were associated with adverse birth outcomes; however, after controlling for medical complications, these were no longer associated. Our study results indicate that antenatal depressive and/or anxiety symptoms were not independently associated with adverse birth outcomes, a reassuring finding for women who are already psychologically vulnerable during pregnancy.
孕期母亲心理困扰是各种分娩并发症的潜在风险因素。本研究旨在探讨与不良分娩结局相关的心理因素。对来自澳大利亚和新西兰的285名女性在产前两个时间点评估心理困扰症状、个体特征和医学并发症；在2014年1月至2015年9月期间产后评估分娩结局。进行分层多元回归分析以检验心理困扰与不良分娩结局之间的关系。孕期的医学并发症，如严重感染、胎盘问题和先兆子痫，以及产前使用大麻，是与不良分娩结局最密切相关的因素，占总方差的22%（p <.001）。抑郁和/或焦虑症状、低社会支持和低连贯感与分娩并发症无关。在未调整的分析中，孕期自我报告的焦虑症诊断和倾向于监管型育儿方式与不良分娩结局相关；然而，在控制医学并发症后，这些不再相关。我们的研究结果表明，产前抑郁和/或焦虑症状与不良分娩结局无独立关联，这对孕期已经存在心理脆弱性的女性来说是一个令人安心的发现。
