Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Department of Psychology, Reykjavik University, Menntavegur 1, 101, Reykjavik, Iceland.
Arch Womens Ment Health. 2019 Feb;22(1):75-83. doi: 10.1007/s00737-018-0881-7. Epub 2018 Jul 28.
Risk factors for antenatal common mental problems include a history of depression, lack of social support and a history of both childhood and adulthood sexual and physical abuse. However, it is less clear whether pregnancy is a time of particular susceptibility to mental disorders due to prior childhood experiences. The aim of the paper was to investigate the potential pathways to antenatal mental health problems. A total of 521 women attending prenatal care attended a clinical interview and answered psychological questionnaires. Univariate analysis, sequential binary logistic regression and structural equation modelling (SEM) were used to analyse the relationships between variables. Having experienced parental maladjustment, maltreatment and serious physical illness in childhood and domestic violence, financial difficulties and serious spousal substance abuse in adulthood significantly predicted antenatal common mental health symptoms. SEM showed that history of depression and adverse experiences in adulthood had mediating effects on the relationship between adverse childhood events and symptoms of antenatal common mental disorders. Adverse childhood experiences are distal risk factors for antenatal common mental health problems, being significant indicators of history of depression and adverse experiences in adulthood. We therefore conclude that pregnancy is not a time of particular susceptibility to common mental health problems as a result of childhood abuse, but rather, these childhood experiences have increased the risk of adulthood trauma and prior mental disorders. Women at risk for antenatal common mental disorders include those with a history of depression, domestic violence, financial difficulties, spousal substance abuse and lack of social support.
产前常见精神问题的危险因素包括抑郁史、缺乏社会支持以及儿童期和成年期性和身体虐待史。然而，由于之前的儿童期经历，孕期是否是精神障碍特别易感性的时期还不太清楚。本文旨在探讨产前心理健康问题的潜在途径。共有 521 名参加产前护理的妇女接受了临床访谈并回答了心理问卷。采用单变量分析、序贯二元逻辑回归和结构方程模型（SEM）分析变量之间的关系。在儿童期经历父母失调、虐待和严重身体疾病以及成年期的家庭暴力、经济困难和严重配偶物质滥用的女性，产前常见精神健康症状显著预测。SEM 显示，抑郁史和成年期的不良经历对童年期不良事件与产前常见精神障碍症状之间的关系具有中介作用。童年期不良经历是产前常见精神健康问题的远端危险因素，是抑郁史和成年期不良经历的重要指标。因此，我们得出结论，孕期并不是由于儿童期虐待导致常见精神健康问题的特殊易感性时期，而是这些儿童期经历增加了成年期创伤和先前精神障碍的风险。有产前常见精神障碍风险的女性包括有抑郁史、家庭暴力、经济困难、配偶物质滥用和缺乏社会支持的女性。
