Department of Gynecology and Obstetrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
Reproductive Medicine Center, Zhongshan Hospital, Fudan University, Shanghai, China.
Arch Gynecol Obstet. 2019 Oct;300(4):1061-1066. doi: 10.1007/s00404-019-05264-z. Epub 2019 Aug 21.
To investigate the prevalence and explore potential risk factors of depression and anxiety in patients with recurrent pregnancy loss (RPL).
1138 non-pregnant women aged 20-40 years old who attempted to conceive were invited to complete a questionnaire, including basic information, Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS).
782 RPL women, 218 women with one pregnancy loss and 138 women with no history of pregnancy loss were included in this study. We found that both RPL patients and women with one pregnancy loss had significantly higher SDS and SAS scores than the control group (P = 0.006, 0.003). Furthermore, in RPL patients, those with lower education level (lower than university), lower household income (< 10,000 yuan) and history of induced abortion had significantly higher levels of depression and anxiety. Women with multiple pregnancy losses ( ≥ 3) and no live birth had significantly higher SDS scores. Women who had been married for 3 years or more had a significantly higher SAS score. Logistic regression revealed that lower education level (lower than university) was an independent risk factor for depression (adjusted OR = 1.75, 95% CI 1.10-2.77, P = 0.018) and anxiety (adjusted OR = 1.80, 95% CI 1.04-3.13, P = 0.037), and women with three or more pregnancy losses had increased odds of depression than those with two pregnancy losses (adjusted OR = 1.82, 95% CI 1.15-2.88, P = 0.012).
RPL patients are more likely to develop depression and anxiety than women with no history of pregnancy loss. Lower education level and multiple pregnancy losses (≥ 3) appear to be two independent risk factors of depression and anxiety in women with RPL. Women with one pregnancy loss also show a significant higher level for depression and anxiety. Appropriate psychological intervention can be considered for such patients.
调查复发性妊娠丢失（RPL）患者抑郁和焦虑的患病率，并探讨其潜在的危险因素。
邀请 1138 名年龄在 20-40 岁之间的非孕妇填写问卷，内容包括基本信息、抑郁自评量表（SDS）和焦虑自评量表（SAS）。
本研究纳入 782 名 RPL 患者、218 名 1 次妊娠丢失患者和 138 名无妊娠丢失史的患者。结果显示，RPL 患者和 1 次妊娠丢失患者的 SDS 和 SAS 评分均显著高于对照组（P=0.006，0.003）。此外，在 RPL 患者中，文化程度较低（低于大学）、家庭收入较低（<10000 元）和有流产史的患者抑郁和焦虑程度显著较高。多次妊娠丢失（≥3 次）且无活产的患者 SDS 评分显著较高。结婚 3 年以上的患者 SAS 评分显著较高。Logistic 回归分析显示，文化程度较低（低于大学）是抑郁的独立危险因素（调整 OR=1.75，95%CI 1.10-2.77，P=0.018）和焦虑的独立危险因素（调整 OR=1.80，95%CI 1.04-3.13，P=0.037），3 次及以上妊娠丢失的患者发生抑郁的可能性是 2 次妊娠丢失的患者的 1.82 倍（调整 OR=1.82，95%CI 1.15-2.88，P=0.012）。
与无妊娠丢失史的女性相比，RPL 患者更易发生抑郁和焦虑。文化程度较低和多次妊娠丢失（≥3 次）似乎是 RPL 患者抑郁和焦虑的两个独立危险因素。1 次妊娠丢失的患者也表现出显著较高的抑郁和焦虑水平。对于此类患者，可考虑进行适当的心理干预。
