Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria.
Institute of Maternal and Child Health, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Nsukka, Nigeria.
Int J Psychiatry Med. 2024 May;59(3):303-324. doi: 10.1177/00912174231199215. Epub 2023 Aug 29.
The primary purpose of this study was to examine whether pregnant women with a history of recurrent pregnancy loss (RPL) are more likely to experience moderate-to-severe depression, anxiety, or stress symptoms than pregnant women without a history of RPL. The secondary purpose was to determine whether women with prior RPL experienced more unfavorable pregnancy outcomes if they had depression, anxiety, or stress.
A prospective case-control study was conducted that included 47 pregnant women with a history of RPL and 94 pregnant women without prior RPL. Participants 20 weeks of gestation or earlier were included. Both groups completed the Depression, Anxiety, and Stress Scale (DASS-21), and were followed up until delivery to determine the pregnancy outcomes. Multivariate logistic regression was used to compare adverse pregnancy outcomes.
Among the 47 women with prior RPL, 10 had primary RPL (two or more miscarriages without a successful pregnancy) and 37 secondary RPL (two or more miscarriages with a history of successful pregnancy). RPL was significantly associated with moderate-to-severe levels of depression ( < .001), anxiety ( < .001), and stress ( < .001). Among the RPL group, high stress level was significantly associated with repeat miscarriage (adjusted odds ratio (AOR) = 5.28, 95%CI = 1.25-100.0, = .03) and preterm labor (AOR = 6.07, 95%CI = 1.61-100.0, = .04). Depression and anxiety were not associated with adverse pregnancy outcomes.
Pregnant women with a history of RPL had considerably higher rates of moderate-to-severe depression, anxiety, and stress. Repeat miscarriage and preterm labor were considerably higher among pregnant women with RPL who were experiencing high stress levels at baseline.
本研究的主要目的是探讨复发性妊娠丢失（RPL）史的孕妇是否比无 RPL 史的孕妇更易出现中重度抑郁、焦虑或压力症状。次要目的是确定如果 RPL 史的女性有抑郁、焦虑或压力，她们是否会经历更不利的妊娠结局。
进行了一项前瞻性病例对照研究，纳入了 47 名有 RPL 史的孕妇和 94 名无既往 RPL 史的孕妇。纳入妊娠 20 周或更早的孕妇。两组均完成抑郁、焦虑和压力量表（DASS-21），并随访至分娩，以确定妊娠结局。采用多变量逻辑回归比较不良妊娠结局。
在 47 名有既往 RPL 的孕妇中，10 名有原发性 RPL（两次或更多流产而无成功妊娠），37 名有继发性 RPL（两次或更多流产且有成功妊娠史）。RPL 与中重度抑郁（<0.001）、焦虑（<0.001）和压力（<0.001）显著相关。在 RPL 组中，高压力水平与复发性流产（调整优势比（AOR）=5.28，95%CI=1.25-100.0，=0.03）和早产（AOR=6.07，95%CI=1.61-100.0，=0.04）显著相关。抑郁和焦虑与不良妊娠结局无关。
有 RPL 史的孕妇中重度抑郁、焦虑和压力的发生率明显较高。在基线时压力水平较高的 RPL 孕妇中，复发性流产和早产的发生率明显较高。
