Promenta Research Centre, Department of Psychology, University of Oslo, PB 1094 Blindern, 0317, Oslo, Norway.
Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
BMC Psychiatry. 2021 Dec 7;21(1):609. doi: 10.1186/s12888-021-03620-5.
The overall aim of this study is to examine the effect of prenatal maternal anxiety on birthweight and gestational age, controlling for shared family confounding using a sibling comparison design.
The data on 77,970 mothers and their 91,165 children from the population-based Mother, Father and Child Cohort Study and data on 12,480 pairs of siblings were used in this study. The mothers filled out questionnaires for each unique pregnancy, at 17 and 30 week in pregnancy. Gestational age and birth weight was extracted from the Medical Birth Registry of Norway (MBRN). Associations between prenatal maternal anxiety (measured across the 17 and 30 weeks) and birth outcomes (birthweight and gestational age) were examined using linear regression with adjustment for shared-family confounding in a sibling comparison design.
In the population level analysis the maternal anxiety score during pregnancy was inversely associated with new-born's birthweight (Beta = -63.8 95% CI: -92.6, -35.0) and gestational age (Beta = -1.52, 95% CI: -2.15, -0.89) after adjustment for several covariates. The association of the maternal anxiety score with birthweight was no longer significant, but remained for maternal anxiety at 30 week with gestational age (Beta = -1.11, 95% CI: -1.82, -0.4) after further adjusting for the shared-family confounding in the sibling comparison design.
No association was found for maternal prenatal anxiety with birth weight after multiple covariates and family environment were controlled. However, there was an association between prenatal maternal anxiety at 30 week only with gestational age, suggesting a timing effect for maternal anxiety in third trimester.
本研究的总体目标是通过兄弟姐妹比较设计，控制共享家庭混杂因素，检验产前母亲焦虑对出生体重和胎龄的影响。
本研究使用了基于人群的母亲、父亲和儿童队列研究中 77970 名母亲及其 91165 名儿童的数据以及 12480 对兄弟姐妹的数据。母亲在每次独特的妊娠时填写问卷，分别在妊娠 17 周和 30 周。挪威医学出生登记处（MBRN）提取了胎龄和出生体重数据。使用线性回归，在兄弟姐妹比较设计中调整共享家庭混杂因素，对产前母亲焦虑（在妊娠 17 周和 30 周测量）与出生结局（出生体重和胎龄）之间的关联进行了检验。
在人群水平分析中，调整了几个协变量后，妊娠期间母亲焦虑评分与新生儿出生体重（β=-63.8，95%CI：-92.6，-35.0）和胎龄（β=-1.52，95%CI：-2.15，-0.89）呈负相关。进一步调整兄弟姐妹比较设计中的共享家庭混杂因素后，母亲焦虑评分与出生体重的关联不再显著，但与 30 周时的母亲焦虑与胎龄仍存在关联（β=-1.11，95%CI：-1.82，-0.4）。
在控制了多个协变量和家庭环境后，未发现母亲产前焦虑与出生体重之间存在关联。然而，仅在 30 周时，母亲产前焦虑与胎龄之间存在关联，提示母亲在妊娠晚期的焦虑存在时间效应。
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