Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK.
Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark.
Int J Epidemiol. 2023 Aug 2;52(4):993-1002. doi: 10.1093/ije/dyac198.
Parental leave policies have been hypothesized to benefit mothers' mental health. We assessed the impact of a 6-week extension of parental leave in Denmark on maternal mental health.
We linked individual-level data from Danish national registries on maternal sociodemographic characteristics and psychiatric diagnoses. A regression discontinuity design was applied to study the increase in parental leave duration after 26 March 1984. We included women who had given birth between 1 January 1981 and 31 December 1987. Our outcome was a first psychiatric diagnosis following the child's birth, ascertained as the first day of inpatient hospital admission for any psychiatric disorder. We presented cumulative incidences for the 30-year follow-up period and reported absolute risk differences between women eligible for the reform vs not, in 5-year intervals.
In all, 291 152 women were followed up until 2017, death, emigration or date of first psychiatric diagnosis. The median follow-up time was 29.99 years, corresponding to 10 277 547 person-years at risk. The cumulative incidence of psychiatric diagnoses at 30 years of follow-up was 59.5 (95% CI: 57.4 to 61.6) per 1000 women in the ineligible group and 57.5 (95% CI: 55.6 to 59.4) in the eligible group. Eligible women took on average 32.85 additional days of parental leave (95% CI: 29.20 to 36.49) and had a lower probability of having a psychiatric diagnosis within 5 years [risk difference (RD): 2.4 fewer diagnoses per 1000 women, 95% CI: 1.5 to 3.2] and up to 20 years after the birth (RD: 2.3, 95% CI: 0.4 to 4.2). In subgroup analyses, the risk reduction was concentrated among low-educated, low-income and single women.
Longer parental leave may confer mental health benefits to women, in particular to those from disadvantaged backgrounds.
人们推测，父母假政策有利于母亲的心理健康。我们评估了丹麦将父母假延长 6 周对产妇心理健康的影响。
我们将丹麦国家登记册中关于产妇社会人口特征和精神科诊断的个人数据进行了关联。采用回归不连续性设计研究了 1984 年 3 月 26 日后父母假持续时间的增加。我们纳入了 1981 年 1 月 1 日至 1987 年 12 月 31 日之间分娩的女性。我们的结果是孩子出生后首次出现的精神科诊断，通过任何精神障碍住院治疗的第一天确定。我们报告了 30 年随访期间的累积发病率，并以 5 年为间隔报告了符合改革条件与不符合条件的女性之间的绝对风险差异。
共有 291152 名女性接受了随访，直至 2017 年死亡、移民或首次出现精神科诊断。中位随访时间为 29.99 年，相当于 10277547 人年的风险暴露。30 年随访期间精神科诊断的累积发病率在不符合条件组为 59.5（95%CI：57.4 至 61.6）/1000 名女性，在符合条件组为 57.5（95%CI：55.6 至 59.4）/1000 名女性。符合条件的女性平均多休 32.85 天的父母假（95%CI：29.20 至 36.49），并且在 5 年内出现精神科诊断的可能性较低[风险差异（RD）：每 1000 名女性减少 2.4 例诊断，95%CI：1.5 至 3.2]，在孩子出生后 20 年内也是如此（RD：2.3，95%CI：0.4 至 4.2）。在亚组分析中，这种风险降低主要集中在受教育程度低、收入低和单身的女性中。
延长父母假可能会给女性带来心理健康益处，特别是给那些处于不利背景的女性。
