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年轻孕妇与精神障碍风险:来自一个早孕队列的研究结果

Young pregnant women and risk for mental disorders: findings from an early pregnancy cohort.

作者信息

Lockwood Estrin Georgia, Ryan Elizabeth G, Trevillion Kylee, Demilew Jill, Bick Debra, Pickles Andrew, Howard Louise Michele

机构信息

Senior Research Associate,Section of Women's Mental Health,Institute of Psychiatry,Psychology and Neuroscience,King's College London;and Research Fellow,Centre for Brain and Cognitive Development,Birkbeck College,UK.

Senior Research Fellow,Biostatistics and Health Informatics Department,Institute of Psychiatry, Psychology and Neuroscience,King's College London;and Clinical Trials Unit,Warwick Medical School,University of Warwick,UK.

出版信息

BJPsych Open. 2019 Mar;5(2):e21. doi: 10.1192/bjo.2019.6.

Abstract

BACKGROUND

Young women aged 16-24 are at high risk of common mental disorders (CMDs), but the risk during pregnancy is unclear.AimsTo compare the population prevalence of CMDs in pregnant women aged 16-24 with pregnant women ≥25 years in a representative cohort, hypothesising that younger women are at higher risk of CMDs (depression, anxiety disorders, post-traumatic stress disorder, obsessive-compulsive disorder), and that this is associated with low social support, higher rates of lifetime abuse and unemployment.

METHOD

Analysis of cross-sectional baseline data from a cohort of 545 women (of whom 57 were aged 16-24 years), attending a South London maternity service, with recruitment stratified by endorsement of questions on low mood, interviewed with the Structured Clinical Interview DSM-IV-TR.

RESULTS

Population prevalence estimates of CMDs were 45.1% (95% CI 23.5-68.7) in young women and 15.5% (95% CI 12.0-19.8) in women ≥25, and for 'any mental disorder' 67.2% (95% CI 41.7-85.4) and 21.2% (95% CI 17.0-26.1), respectively. Young women had greater odds of having a CMD (adjusted odds ratio (aOR) = 5.8, 95% CI 1.8-18.6) and CMDs were associated with living alone (aOR = 3.0, 95% CI 1.1-8.0) and abuse (aOR = 1.5, 95% CI 0.8-2.8).

CONCLUSIONS

Pregnant women between 16 and 24 years are at very high risk of mental disorders; services need to target resources for pregnant women under 25, including those in their early 20s. Interventions enhancing social networks, addressing abuse and providing adequate mental health treatment may minimise adverse outcomes for young women and their children.Declaration of interestNone.

摘要

背景

16 - 24岁的年轻女性患常见精神障碍(CMD)的风险较高,但孕期风险尚不清楚。

目的

在一个具有代表性的队列中,比较16 - 24岁孕妇与25岁及以上孕妇中CMD的人群患病率,假设年轻女性患CMD(抑郁症、焦虑症、创伤后应激障碍、强迫症)的风险更高,且这与社会支持低、终身受虐待率和失业率高有关。

方法

对来自伦敦南部一家产科服务机构的545名女性队列(其中57名年龄在16 - 24岁之间)的横断面基线数据进行分析,招募过程根据对情绪低落问题的认可程度进行分层,并采用《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)结构化临床访谈进行访谈。

结果

年轻女性中CMD的人群患病率估计为45.1%(95%可信区间23.5 - 68.7),25岁及以上女性为15.5%(95%可信区间12.0 - 19.8);“任何精神障碍”的患病率分别为67.2%(95%可信区间41.7 - 85.4)和21.2%(95%可信区间17.0 - 26.1)。年轻女性患CMD的几率更高(调整后的优势比(aOR)= 5.8,95%可信区间1.8 - 18.6),CMD与独居(aOR = 3.0,95%可信区间1.1 - 8.0)和受虐待(aOR = 1.5,95%可信区间0.8 - 2.8)有关。

结论

16至24岁的孕妇患精神障碍的风险非常高;服务需要针对25岁以下的孕妇,包括20岁出头的孕妇,分配资源。加强社交网络、解决受虐待问题并提供适当的心理健康治疗的干预措施可能会将年轻女性及其子女的不良后果降至最低。

利益声明

无。

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