Bartel Severine, Costa Serban Dan, Kropf Siegfried, Redlich Anke, Rissmann Anke
Fehlbildungsmonitoring Sachsen-Anhalt, Medizinische Fakultät der Otto-von-Guericke Universität Magdeburg, Magdeburg, Germany.
Universitätsfrauenklinik Magdeburg, Medizinische Fakultät der Otto-von-Guericke Universität Magdeburg, Magdeburg, Germany.
Geburtshilfe Frauenheilkd. 2017 Nov;77(11):1189-1199. doi: 10.1055/s-0043-120920. Epub 2017 Nov 27.
Worldwide the prevalence of neuropsychiatric illness among women of reproductive age is higher than ever before. This study investigates the influences of maternal substance abuse/dependence and neuropsychiatric illness on pregnancy and neonatal outcomes.
Using a retrospective study design 185 pregnancies in women with neuropsychiatric illnesses or substance abuse were identified at a single centre over a period of 3.25 years and compared to 4907 pregnancies in healthy women without mental illness. Differences in pre-, peri- and postnatal pregnancy parameters were studied.
Numbers of previous abortions on obstetric history were significantly higher in cases compared to controls, women with depression being especially affected. The number of antenatal visits was also higher among cases, especially in women with depression. The caesarean section rate was significantly higher in cases compared to controls. Children of women with neuropsychiatric illness were born at lower gestational ages than those of healthy control mothers, however there were no significant differences between case and control groups for birth weight, head circumference or Apgar scores. Some isolated differences were found for disease-specific case subgroups compared to controls.
The study shows a relationship between maternal neuropsychiatric illness and pregnancy outcomes independent of medication use. Rates of spontaneous abortion were higher. Children were born earlier, yet the neonatal outcomes birth weight, head circumference and Apgar score were not worse than children of mentally healthy women.
在全球范围内，育龄妇女神经精神疾病的患病率比以往任何时候都高。本研究调查了母亲药物滥用/依赖和神经精神疾病对妊娠及新生儿结局的影响。
采用回顾性研究设计，在一个中心3.25年期间确定了185例患有神经精神疾病或药物滥用的妇女的妊娠情况，并与4907例无精神疾病的健康妇女的妊娠情况进行比较。研究了产前、产时和产后妊娠参数的差异。
与对照组相比，病例组产科病史中既往流产次数显著更高，抑郁症患者尤其受影响。病例组的产前检查次数也更多，尤其是抑郁症患者。与对照组相比，病例组的剖宫产率显著更高。患有神经精神疾病的妇女所生子女的孕周低于健康对照母亲所生子女，但病例组和对照组在出生体重、头围或阿氏评分方面无显著差异。与对照组相比，特定疾病病例亚组存在一些孤立的差异。
该研究表明母亲神经精神疾病与妊娠结局之间存在独立于药物使用的关系。自然流产率更高。孩子出生更早，但新生儿结局出生体重、头围和阿氏评分并不比心理健康妇女的孩子差。
