Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya 466-8550, Aichi, Japan.
Department of Obstetrics and Gynecology, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-Cho, Anjo 446-8602, Aichi, Japan.
Int J Environ Res Public Health. 2021 Aug 29;18(17):9122. doi: 10.3390/ijerph18179122.
Mental illnesses commonly occur in the reproductive age. This study aimed to identify the issues that exist within the perinatal mental health care system. A cross-sectional survey was conducted in Aichi Prefecture in central Japan. Questionnaires on the situation between 2016 and 2018 were mailed to the head physicians of 128 maternity care units, 21 neonatal intensive care units (NICUs), and 40 assisted reproductive technology (ART) units. A total of 82 (52.6 per 100,000 births) women were admitted to mental health care units during the perinatal period, and 158 (1.0 per 1000 births) neonates born to mothers with mental illness were admitted to NICUs. Approximately 40% of patients were hospitalized in psychiatric hospitals without maternity care units. Eighty-four (71.1%) and 76 (64.4%) maternity care units did not have psychiatrists or social workers, respectively. Moreover, 20-35% of the head physicians in private clinics, general hospitals, and ART units endorsed the discontinuation of psychotropic drug use during pregnancy. However, the corresponding figures were only 5% among those in maternal-fetal centers. Resources for perinatal mental illness might be limited. Perspectives on psychotropic drug use differed based on the type of facilities where the doctors were working.
精神疾病在生育年龄中较为常见。本研究旨在确定围产期心理健康护理系统中存在的问题。在日本中部的爱知县进行了一项横断面调查。2016 年至 2018 年间,向 128 家产科护理单位、21 家新生儿重症监护病房(NICU)和 40 家辅助生殖技术(ART)单位的首席医师邮寄了问卷。共有 82 名(每 100,000 名分娩 52.6 名)妇女在围产期入住心理健康护理单位,158 名(每 1000 名分娩 1.0 名)患有精神疾病的母亲所生的新生儿入住 NICU。约有 40%的患者在没有产科病房的精神病院住院。84 名(71.1%)和 76 名(64.4%)产科病房分别没有精神病医生或社会工作者。此外,20-35%的私人诊所、综合医院和 ART 单位的首席医师赞成在怀孕期间停止使用精神药物。然而,在母婴中心工作的医生中,这一数字仅为 5%。围产期精神疾病的资源可能有限。对精神药物使用的看法因医生工作的医疗机构类型而异。