Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco.
Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Stanford University, Stanford, California, USA.
Curr Opin Obstet Gynecol. 2019 Apr;31(2):116-119. doi: 10.1097/GCO.0000000000000524.
Maternal mental health disorders, including anxiety and depression, are one of the most common obstetric complications, presenting in pregnancy and postpartum.
Maternal mental health disorders are associated with adverse maternal and neonatal outcomes. Screening women in pregnancy and postpartum for mental health disorders is key to early identification and treatment of anxiety and depression in the perinatal population. Although universal screening is now recommended by numerous professional organizations, rates of screening are low and often not performed with a validated screening instrument. Although clinical assessment is important, it is insufficient to identify maternal mental health disorders. As symptoms may change throughout pregnancy, screening for anxiety and depression should be done at multiple time points in pregnancy, including intake and postpartum. In addition, it is important to complete a mental health history on intake to identify women who are either at risk for, or experiencing, anxiety and depression. All screening programmes must be accompanied by a protocol to respond to a positive screen to ensure appropriate follow-up and treatment.
Identification and treatment of maternal mental health disorders has important implications for maternal and child health. Obstetric providers should screen all women using a validated screening instrument and have systems in place to ensure timely diagnosis and treatment.
孕产妇精神障碍，包括焦虑和抑郁，是最常见的产科并发症之一，可发生于妊娠和产后。
孕产妇精神障碍与母婴不良结局相关。对妊娠和产后女性进行精神障碍筛查是识别和治疗围产期人群焦虑和抑郁的关键。尽管许多专业组织现在建议进行普遍筛查，但筛查率较低，且通常未使用经过验证的筛查工具进行。虽然临床评估很重要，但它不足以识别孕产妇精神障碍。由于症状可能在整个孕期发生变化，因此应在孕期的多个时间点（包括初诊和产后）筛查焦虑和抑郁。此外，在初诊时完成精神病史评估以识别有焦虑和抑郁风险或正在经历焦虑和抑郁的女性也很重要。所有的筛查项目都必须有一个针对阳性筛查的处理方案，以确保进行适当的随访和治疗。
识别和治疗孕产妇精神障碍对母婴健康有重要影响。产科医生应使用经过验证的筛查工具对所有女性进行筛查，并建立相应的系统，以确保及时诊断和治疗。
