Suzuki Shunji
a Department of Obstetrics and Gynecology , Japanese Red Cross Katsushika Maternity Hospital , Tokyo , Japan.
J Matern Fetal Neonatal Med. 2018 Aug;31(16):2131-2135. doi: 10.1080/14767058.2017.1336761. Epub 2017 Jun 15.
Recently, we have been providing comprehensive treatment for pregnant women with mental disorders involving specialists from multiple fields in cooperation with local administrative agencies. In this study, we examined the outcomes of treatment for women with perinatal mental disorders in our institute to evaluate the effect of our recent approach to improve perinatal mental health.
We retrospectively compared the outcomes between pregnant women with mental disorders who delivered from April 2015 to March 2017 with those from April 2009 to March 2011. We examined the following: presence or absence of necessity of medication, self-interruption of medication, deterioration/relapse of mental disorders, and administrative support.
There was no significant difference in the rate of pregnant women with mental disorders between the two periods (3.2 versus 3.2%, respectively, p = .94). The rates of patients requiring medication and those with self-interruption of medication did not reach significance (p = .90 and .19, respectively) between the two periods; however, the rate of patients with deterioration/relapse of mental disorders decreased significantly during pregnancy and postpartum (20.3 versus 10.7 and 7.3 versus 1.7%, p = .04 and .03, respectively). On the other hand, the patients receiving administrative supports increased significantly over the total study period (p < .01).
It was suggested that our recent active management of pregnant women with mental disorders might have contributed to prevent the deterioration/relapse of mental disorders during pregnancy and postpartum.
最近,我们与当地行政机构合作,为患有精神障碍的孕妇提供了多领域专家参与的综合治疗。在本研究中,我们调查了我院围产期精神障碍女性的治疗结果,以评估我们近期改善围产期心理健康方法的效果。
我们回顾性比较了2015年4月至2017年3月分娩的患有精神障碍的孕妇与2009年4月至2011年3月分娩的孕妇的治疗结果。我们调查了以下方面:是否需要药物治疗、自行中断药物治疗情况、精神障碍恶化/复发情况以及行政支持情况。
两个时期患有精神障碍的孕妇比例无显著差异(分别为3.2%和3.2%,p = 0.94)。两个时期需要药物治疗的患者比例和自行中断药物治疗的患者比例均无统计学意义(分别为p = 0.90和0.19);然而,在孕期和产后精神障碍恶化/复发的患者比例显著下降(分别为20.3%对10.7%以及7.3%对1.7%,p分别为0.04和0.03)。另一方面,在整个研究期间接受行政支持的患者显著增加(p < 0.01)。
提示我们近期对患有精神障碍孕妇的积极管理可能有助于预防孕期和产后精神障碍的恶化/复发。