Takeda Eri, Suzumori Nobuhiro, Ebara Takeshi, Yotsumoto Junko, Kumagai Kyoko, Oseto Kumiko, Numabe Hironao, Sugiura-Ogasawara Mayumi
Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Department of Genetic Counseling, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan.
J Obstet Gynaecol Res. 2018 Jan;44(1):35-42. doi: 10.1111/jog.13483. Epub 2017 Oct 13.
The purpose of this study was to clarify the characteristics of psychological mental distress in post-partum women after non-invasive prenatal testing (NIPT) in Japan.
Psychological mental distress was assessed using the Kessler Psychological Distress Scale (K6). We compared patients with (i) low pre-NIPT K6 and low post-partum K6 scores (control group), and (ii) low pre-NIPT K6 and a high post-partum K6 scores (case group).
Among the 697 women who underwent NIPT, 29 (4.2%) had low pre-NIPT K6 and high post-partum K6 scores (case group) and 668 (95.8%) had low pre-NIPT K6 and low post-partum K6 scores (control). Among women with negative NIPT findings, post-partum women with a high K6 score were compared to a control group of women with a low K6 score. Logistic regression analysis showed that primiparity (P = 0.007), low birthweight (P = 0.005) and use of intracytoplasmic sperm injection (P = 0.02) and assisted reproductive technology (P = 0.05) were significantly different between the groups.
Even if women do not feel mental distress before NIPT, they may develop mental stress post-partum. In particular, primipara women who conceived through assisted reproductive technology (especially intracytoplasmic sperm injection) and gave birth to a low birthweight baby were more susceptible to developing post-partum distress. Thus, it is important to educate women that support is available, with consultation with other healthcare professionals during genetic counseling if necessary. Further studies are needed in order to determine the factors associated with post-partum mental distress.
本研究旨在阐明日本无创产前检测（NIPT）后产后女性心理精神困扰的特征。
使用凯斯勒心理困扰量表（K6）评估心理精神困扰。我们比较了两组患者：（i）NIPT前K6评分低且产后K6评分低的患者（对照组），以及（ii）NIPT前K6评分低且产后K6评分高的患者（病例组）。
在接受NIPT的697名女性中，29名（4.2%）NIPT前K6评分低且产后K6评分高（病例组），668名（95.8%）NIPT前K6评分低且产后K6评分低（对照组）。在NIPT结果为阴性的女性中，将产后K6评分高的女性与K6评分低的女性对照组进行比较。逻辑回归分析显示，两组之间初产（P = 0.007）、低出生体重（P = 0.005）以及使用胞浆内单精子注射（P = 0.02）和辅助生殖技术（P = 0.05）存在显著差异。
即使女性在NIPT前没有感到精神困扰，她们在产后也可能产生精神压力。特别是通过辅助生殖技术（尤其是胞浆内单精子注射）受孕并生下低出生体重婴儿的初产妇更容易出现产后困扰。因此，重要的是要告知女性有可用的支持，如果有必要，在遗传咨询期间与其他医疗保健专业人员进行协商。为了确定与产后精神困扰相关的因素，还需要进一步的研究。
