Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana; South Central Mental Illness Research, Education and Clinical Center; Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, Louisiana.
VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
Womens Health Issues. 2023 Jul-Aug;33(4):422-427. doi: 10.1016/j.whi.2023.03.006. Epub 2023 Apr 24.
Pregnancy loss, including miscarriage and stillbirth, is common and associated with an increased risk for prenatal and postnatal depression, as well as posttraumatic stress disorder (PTSD). Racial disparities have been observed in pregnancy loss, with Black women having higher rates of pregnancy loss and postnatal depression. However, no research to date has examined the mental health and demographic correlates of pregnancy loss within a veteran population.
The current study examined associations between pregnancy loss and mental health and demographic correlates among 1,324 pregnant veterans, of which 368 had a history of at least one stillbirth and/or miscarriage.
Veterans with a history of pregnancy loss, compared with those without, were more likely to have a diagnosis of anxiety (52.7% vs. 46.4%, p = .04), depression (62.5% vs. 50.8%, p = .0001), or PTSD (46.5% vs. 37.6%, p = .003); were more likely to report receiving mental health care during pregnancy (23.1% vs. 16.8%, p = .01); and were more likely to have experienced military sexual trauma (harassment: 56.5% vs. 49.9%, p = .04; rape: 38.9% vs. 29.3%, p = .0004). Results also indicated that Black veterans were more likely to report a history of pregnancy loss (32.1% vs. 25.3%, p = .01). Further, Black veterans were more likely to experience clinically meaningful prenatal depression symptoms (adjusted odds ratio: 1.90; 95% confidence interval: 1.42-2.54) after accounting for past loss and age in logistic regression models.
Taken together, findings from the present investigation corroborate previous research highlighting the deleterious impact of pregnancy loss and extend prior work by examining these associations among a diverse sample of pregnant veterans.
妊娠丢失，包括流产和死产，较为常见，与产前和产后抑郁以及创伤后应激障碍（PTSD）的风险增加相关。在妊娠丢失方面已经观察到了种族差异，黑人女性的妊娠丢失和产后抑郁发生率更高。然而，迄今为止，没有研究在退伍军人人群中检查妊娠丢失与心理健康和人口统计学因素之间的关系。
本研究检查了 1324 名怀孕退伍军人中妊娠丢失与心理健康和人口统计学因素之间的关联，其中 368 名有至少一次死产和/或流产史。
与没有妊娠丢失史的退伍军人相比，有妊娠丢失史的退伍军人更有可能被诊断为焦虑症（52.7% vs. 46.4%，p=0.04）、抑郁症（62.5% vs. 50.8%，p=0.0001）或 PTSD（46.5% vs. 37.6%，p=0.003）；更有可能在怀孕期间接受心理健康护理（23.1% vs. 16.8%，p=0.01）；并且更有可能经历过军事性创伤（骚扰：56.5% vs. 49.9%，p=0.04；强奸：38.9% vs. 29.3%，p=0.0004）。结果还表明，黑人退伍军人更有可能报告有妊娠丢失史（32.1% vs. 25.3%，p=0.01）。此外，在考虑过去的损失和年龄后，黑人退伍军人在逻辑回归模型中更有可能经历具有临床意义的产前抑郁症状（调整后的优势比：1.90；95%置信区间：1.42-2.54）。
总的来说，本研究的结果证实了之前的研究结果，强调了妊娠丢失的有害影响，并通过在多样化的怀孕退伍军人样本中检查这些关联，扩展了之前的研究。
