Vigod Simone N, Bagadia Ashlesha J, Hussain-Shamsy Neesha, Fung Kinwah, Sultana Anjum, Dennis Cindy-Lee E
Women's College Hospital and Research Institute, 76 Grenville Street, Toronto, ON, Canada.
University of Toronto, 27 King's College Circle, Toronto, ON, Canada.
Arch Womens Ment Health. 2017 Jun;20(3):439-447. doi: 10.1007/s00737-017-0721-1. Epub 2017 Apr 4.
Immigrant women are at high risk for postpartum mental disorders. The purpose of this study was to understand how rates of postpartum mental health contact differ among immigrant women by region of origin, time since immigration, and refugee status. We conducted a population-based cohort study of immigrant mothers in Ontario, Canada, with children born from 2008 to 2012 (N = 123,231). We compared risk for mental health contact (outpatient, emergency department, inpatient hospitalization) in the first postpartum year by region of origin, time since immigration, and refugee status, generating adjusted odds ratios (aOR) and 95% confidence intervals (CI). Immigrants from North Africa and the Middle East were more likely to have outpatient mental health contact than a referent group of immigrants from North America or Europe (aOR 1.07, 95% CI 1.01-1.14); those from East Asia and the Pacific, Southern Asia, and Sub-Saharan Africa were less likely (0.64, 0.61-0.68; 0.78, 0.74-0.83; 0.88, 0.81-0.94). Refugees were more likely to have contact than non-refugees (1.10, 1.04-1.15); those in Canada <5 years were less likely than longer-term immigrants (0.83, 0.79-0.87). Refugees were more likely to have an emergency department visit (1.81, 1.50-2.17) and a psychiatric hospitalization than non-refugees (1.78, 1.31-2.42). These findings have implications for targeted postpartum mental health service delivery targeting certain immigrant groups and particularly refugees.
移民妇女产后患精神障碍的风险很高。本研究的目的是了解不同原籍地区、移民时间和难民身份的移民妇女产后心理健康咨询率有何差异。我们对加拿大安大略省2008年至2012年出生孩子的移民母亲进行了一项基于人群的队列研究（N = 123,231）。我们比较了产后第一年按原籍地区、移民时间和难民身份划分的心理健康咨询风险（门诊、急诊科、住院治疗），得出调整后的优势比（aOR）和95%置信区间（CI）。来自北非和中东的移民比北美或欧洲的移民参照组更有可能进行门诊心理健康咨询（aOR 1.07，95% CI 1.01 - 1.14）；来自东亚及太平洋地区、南亚和撒哈拉以南非洲的移民则可能性较小（0.64，0.61 - 0.68；0.78，0.74 - 0.83；0.88，0.81 - 0.94）。难民比非难民更有可能进行咨询（1.10，1.04 - 1.15）；在加拿大居住<5年的移民比长期移民可能性更小（0.83，0.79 - 0.87）。难民比非难民更有可能前往急诊科就诊（1.81，1.50 - 2.17）以及接受精神科住院治疗（1.78，1.31 - 2.42）。这些发现对针对某些移民群体尤其是难民的产后心理健康服务提供具有启示意义。
