Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.
Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Eur Child Adolesc Psychiatry. 2023 Oct;32(10):2001-2008. doi: 10.1007/s00787-022-02029-z. Epub 2022 Jun 30.
Teenage pregnancy is a major public health concern. However, few studies have investigated the relationship between pediatric bipolar disorder and early pregnancy, and whether bipolar disorder medications reduce the risk of early pregnancy remains unknown. In total, 3218 adolescent girls with bipolar disorder and 32,180 controls matched for age, family income, residence, and time of enrollment were enrolled in this study from 2001 to 2009. Early pregnancy, defined as pregnancy occurring in patients younger than 20 years old, was identified during the follow-up period from enrollment until the end of 2011. After adjustment for demographic data, psychiatric comorbidities, and bipolar disorder medications, adolescent girls with bipolar disorder had 20 times the risk of early pregnancy (hazard ratio [HR] = 20.63, 95% confidence interval [CI] [15.68, 27.16]) and about 25 times the risk of repeated early pregnancy (HR = 24.59, 95% CI [15.20, 39.78]) compared with those without bipolar disorder. Long-term use of both mood stabilizers (HR = 0.34, 95% CI [0.23, 0.52]) and atypical antipsychotics (HR = 0.32, 95% CI [0.20, 0.51]) was associated with a reduced risk of early pregnancy. Bipolar disorder was associated with an increased risk of early pregnancy in adolescent girls. Bipolar disorder medications reduced this risk. The results suggest that interventions targeting the vulnerable population of adolescent girls with bipolar disorder are warranted to prevent early pregnancies.
青少年怀孕是一个主要的公共卫生关注点。然而，很少有研究调查儿童双相情感障碍与早期妊娠之间的关系，以及双相情感障碍药物是否降低早期妊娠的风险仍不清楚。本研究共纳入了 3218 例青少年女性双相障碍患者和 32180 名年龄、家庭收入、居住地和入组时间相匹配的对照者，这些患者均于 2001 年至 2009 年期间入组。在随访期间（从入组到 2011 年底），将年龄小于 20 岁的患者所发生的妊娠定义为早期妊娠。在调整了人口统计学数据、精神共病和双相情感障碍药物后，患有双相障碍的青少年女性发生早期妊娠的风险是对照组的 20 倍（风险比[HR] = 20.63，95%置信区间[CI] [15.68, 27.16]），并且发生重复早期妊娠的风险是对照组的 25 倍（HR = 24.59，95% CI [15.20, 39.78]）。长期使用心境稳定剂（HR = 0.34，95% CI [0.23, 0.52]）和非典型抗精神病药物（HR = 0.32，95% CI [0.20, 0.51]）与早期妊娠风险降低相关。双相情感障碍与青少年女性的早期妊娠风险增加相关。双相情感障碍药物降低了这种风险。研究结果表明，有必要针对患有双相情感障碍的青少年这一弱势群体进行干预，以预防早期妊娠。
