Preconception dysmenorrhea as a risk factor for psychological distress in pregnancy: The Japan Environment and Children's Study.

BACKGROUND

Dysmenorrhea influences emotional distress as well as physical suffering in young non-pregnant women. The aim of this study was to assess the potential association between preconception dysmenorrhea and the development of psychological distress during pregnancy.

METHODS

This study was a part of the Japan Environment and Children's Study (JECS), a nationwide birth cohort study conducted between 2011 and 2014 in Japan. A total of 87,102 pregnant Japanese women with no psychological distress (Kessler 6-item psychological distress scale [K6] score ≤ 12) in early pregnancy were eligible. Among these, 7626 had mild and 1638 had severe preconception dysmenorrhea. The prevalence and risk of maternal psychological distress (K6 scores ≥ 13) in the second or third trimester were compared among preconception dysmenorrhea severity groups.

RESULTS

A higher percentage of women with mild (2.6%) or severe preconception dysmenorrhea (3.6%) suffered psychological distress during pregnancy compared to that in women without dysmenorrhea (2.1%). A multilevel logistic regression model, adjusting for baseline characteristics and the K6 score at enrollment, showed that the severity of dysmenorrhea was associated with psychological distress (mild dysmenorrhea: adjusted odds ratio [aOR], 1.154; 95% confidence interval [95% CI], 0.980-1.359; and severe dysmenorrhea: aOR, 1.457; 95% CI, 1.087-1.951).

LIMITATIONS

Information about dysmenorrhea was obtained during early pregnancy. The JECS did not have clear diagnostic criteria for dysmenorrhea.

CONCLUSIONS

Preconception dysmenorrhea is associated with an elevated incidence of psychological distress during pregnancy. Additionally, expectant mothers with a history of severe dysmenorrhea symptoms before pregnancy have a higher risk of developing psychological distress.