Lo Andre C Q, Kemp Michelle, Kabacs Nikolett
School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Department of Obstetrics and Gynaecology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Obstet Med. 2023 Sep;16(3):178-183. doi: 10.1177/1753495X221139565. Epub 2022 Nov 28.
The aim was to explore the impact of the COVID-19 pandemic on perinatal mental health screening, illness and related pregnancy complications/outcomes.
A single-centre retrospective cohort study in mothers giving birth before versus during the pandemic. Primary outcomes were the comparative prevalence/incidence of peripartum psychiatric diagnoses. Secondary outcomes were the pandemic's effect on psychiatric screening accuracy, and on other pregnancy outcomes linked to mental health.
The pandemic did not significantly increase the crude incidence of diagnosed peripartum anxiety (risk ratio (RR) = 1.39, 95% CI = 0.66-2.95), depression (RR = 1.63, 95% CI = 0.72-3.70) or other pregnancy outcomes. In multivariate models, the pandemic decreased Apgar scores and was involved in interaction effects for postpartum mental illness and birthweight. Psychiatric screening at the booking appointment exhibited lower sensitivity in predicting antenatal mental illness (pre-pandemic = 85.71%, pandemic = 25.00%; = 0.035).
The lowered screening sensitivity likely meant mental illness was poorly anticipated/under-detected during the pandemic, leading to no crude increase in perinatal psychiatric diagnoses.
旨在探讨2019年冠状病毒病（COVID-19）大流行对围产期心理健康筛查、疾病及相关妊娠并发症/结局的影响。
一项单中心回顾性队列研究，比较大流行前与大流行期间分娩的母亲情况。主要结局是围产期精神疾病诊断的比较患病率/发病率。次要结局是大流行对精神科筛查准确性以及与心理健康相关的其他妊娠结局的影响。
大流行并未显著增加已诊断的围产期焦虑（风险比（RR）=1.39，95%置信区间（CI）=0.66 - 2.95）、抑郁（RR = 1.63，95% CI = 0.72 - 3.70）或其他妊娠结局的粗发病率。在多变量模型中，大流行降低了阿氏评分，并与产后精神疾病和出生体重的交互作用有关。预约时的精神科筛查在预测产前精神疾病方面表现出较低的敏感性（大流行前 = 85.71%，大流行期间 = 25.00%；P = 0.035）。
筛查敏感性降低可能意味着在大流行期间精神疾病未得到充分预测/检测不足，导致围产期精神疾病诊断粗发病率未增加。
