Yates Rosemary, Anderson Peter J, Lee Katherine J, Doyle Lex W, Cheong Jeanie L Y, Pace Carmen C, Spittle Alicia J, Spencer-Smith Megan, Treyvaud Karli
Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Vic, Australia.
Murdoch Children's Research Institute, Parkville, Vic, Australia.
J Pediatr Psychol. 2022 Mar 5;47(3):327-336. doi: 10.1093/jpepsy/jsab101.
Mothers of children born very preterm (VP) are at increased risk of developing postnatal depression, anxiety, and post-traumatic stress symptoms. However, mental health disorder rates are rarely assessed in this population compared with full-term peers, and it is unclear if postnatal distress symptoms precede higher rates of maternal mental health disorders at 5 years post-birth in both birth groups.
Mothers of children born VP (n = 65; mean [SD] age at birth, 33.9 [5.0]; 72.1% tertiary educated) and full-term (n = 90; mean [SD] age at birth, 33.4 [4.0]; 88.2% tertiary educated) completed questionnaires assessing symptoms of depression, anxiety, and trauma within 4 weeks of birth. At 5 years post-birth, they participated in a structured diagnostic interview assessing mood, anxiety, and trauma-related mental health disorders, both current and over the lifetime.
There was little evidence for differences between mothers in the VP and full-term groups in rates of any mental health disorder at 5 years (VP = 14%, full-term = 14%) or lifetime (VP = 41%, full-term = 37%). In mothers of children born VP, elevated postnatal post-traumatic stress symptoms were associated with higher rates of mental health disorders at 5 years (odds ratio = 21.5, 95% confidence interval = 1.35-342).
Findings suggest that preterm birth may not lead to increased odds of later developing maternal mental health disorders, despite known risks of elevated postnatal distress following a VP birth. However, those with post-traumatic stress symptoms following a VP birth could be more vulnerable, and assessment and monitoring is recommended.
极早产儿（VP）母亲患产后抑郁、焦虑和创伤后应激症状的风险增加。然而，与足月儿母亲相比，该人群的心理健康障碍发生率很少被评估，而且尚不清楚产后痛苦症状是否在两个出生组出生后5年时先于母亲心理健康障碍的较高发生率出现。
极早产儿母亲（n = 65；出生时平均[标准差]年龄为33.9[5.0]岁；72.1%接受过高等教育）和足月儿母亲（n = 90；出生时平均[标准差]年龄为33.4[4.0]岁；88.2%接受过高等教育）在产后4周内完成评估抑郁、焦虑和创伤症状的问卷。在出生后5年时，她们参加了一次结构化诊断访谈，评估当前及一生中与情绪、焦虑和创伤相关的心理健康障碍。
几乎没有证据表明极早产儿组和足月儿组母亲在5年时（极早产儿组 = 14%，足月儿组 = 14%）或一生中（极早产儿组 = 41%，足月儿组 = 37%）任何心理健康障碍的发生率存在差异。在极早产儿母亲中，产后创伤后应激症状升高与5年时较高的心理健康障碍发生率相关（比值比 = 21.5，95%置信区间 = 1.35 - 342）。
研究结果表明，早产可能不会导致母亲日后患心理健康障碍的几率增加，尽管已知极早产分娩后产后痛苦风险升高。然而，极早产分娩后有创伤后应激症状的母亲可能更易患病，建议进行评估和监测。
