Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Asher Center for the Study and Treatment of Depressive Disorders, Northwestern University, Chicago, IL, USA.
Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Asher Center for the Study and Treatment of Depressive Disorders, Northwestern University, Chicago, IL, USA.
J Affect Disord. 2019 Jan 15;243:220-225. doi: 10.1016/j.jad.2018.09.045. Epub 2018 Sep 18.
The hypotheses were: (1) pregnant women with bipolar disorder (BD) have less favorable pregnancy outcomes than unaffected women, and (2) psychotropic treated women with BD have better outcomes than un-medicated women.
This prospective study included 174 mother-infant dyads. Women had BD without psychotropic exposure (BD-NP, n = 38), BD with psychotropic treatment (BD-P, n = 49), or neither psychotropic exposure nor major mood disorder (Comp, n = 87). Maternal characteristics were completed at 20 weeks gestation and evaluated for associations with delivery and birth outcomes. We performed multiple regressions on infant outcomes with adjustment for maternal age, race, employment status, use of illicit drugs and pre-pregnancy BMI.
The BP-P, BP-NP and Comp groups varied significantly on sociodemographic characteristics. Women with BD were more likely to be less educated, unemployed, single, and use tobacco and illicit drugs than women in the Comp group. Compared to women with BD-NP, women with BD-P were more likely to be older and educated. Approximately 10% of all infants were delivered preterm. No significant differences in outcome occurred for APGAR scores < 8, NICU admissions, sex or infant length. Infants of mothers with BD-NP had significantly smaller head circumferences (HC) than the other groups, adjustment for confounding variables mitigated this association.
The overall pregnancy outcomes for women with BD were similar to those in the Comp group. The reduced HC in women with untreated BD appears due to factors related to disadvantaged sociodemographic status, a higher proportion of female births, and/or a protective effect of medication in the BD-P group.
提出以下假设：（1）患有双相情感障碍（BD）的孕妇的妊娠结局不如未受影响的女性，（2）接受精神药物治疗的 BD 女性比未用药的女性有更好的结局。
这项前瞻性研究纳入了 174 对母婴对子。女性无精神药物暴露的 BD（BD-NP，n=38）、BD 伴精神药物治疗（BD-P，n=49）或既无精神药物暴露也无主要心境障碍（Comp，n=87）。在妊娠 20 周时完成了母亲的特征评估，并评估了与分娩和出生结局的相关性。我们对婴儿结局进行了多元回归分析，调整了母亲的年龄、种族、就业状况、使用非法药物和孕前 BMI。
BD-P、BD-NP 和 Comp 组在社会人口学特征上存在显著差异。患有 BD 的女性受教育程度较低、失业、单身、吸烟和使用非法药物的可能性高于 Comp 组的女性。与 BD-NP 组相比，BD-P 组的女性年龄较大、受教育程度较高。约有 10%的婴儿早产。APGAR 评分<8、NICU 入院、性别或婴儿身长无显著差异。与其他组相比，BD-NP 组母亲的婴儿头围明显较小，调整混杂因素后，这种相关性减弱。
BD 女性的整体妊娠结局与 Comp 组相似。未接受治疗的 BD 女性的 HC 减少似乎是由于与不利社会人口地位相关的因素、女性出生比例较高以及/或 BD-P 组药物治疗的保护作用所致。
