Clinical Research Center, Women and Children's Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, China; Chongqing Research Center for Prevention & Control of Maternal and Child Diseases and Public Health, China.
Department of Sleep and Psychology, Women and Children's Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, China.
J Affect Disord. 2025 Jan 1;368:143-150. doi: 10.1016/j.jad.2024.09.044. Epub 2024 Sep 10.
There are multiple risk factors for preterm birth (PTB), one of the most important of which is mood disorders during pregnancy. We aimed to comprehensively investigate the association of both total mental health concerns and ten specific psychiatric symptoms with PTB risk.
A cohort study was performed consisting of 25,175 pregnant women who participated in Women and Children's Hospital of Chongqing Medical University between 2020 and 2022. The Symptom Checklist 90 (SCL-90) was utilized to assess the psychiatric symptoms. Multivariable or multinomial logistic regression was applied to investigate mental health concerns associated with risk of PTB or its different clinical sub-categories, respectively. Sensitivity analyses were further performed to validate the results.
8336 women who met the inclusion criteria were included; of these, 547 (6.6 %) had preterm deliveries, and 2542 (30.5 %) had mental health concerns. Compared with women with healthy minds, women with total mental health concerns had a 29.0 % higher risk of overall PTB (OR = 1.28, 95%CI = 1.07-1.54), medical-induced PTB (OR = 1.49, 95%CI = 1.05-2.13) and spontaneous PTB with premature rupture of membranes (OR = 1.33, 95%CI = 1.01-1.74). As to the specific psychological symptoms, hostility pregnant women had a 55.0 % higher risk of PTB (OR = 1.55, 95%CI = 1.14-2.11). Similar results were observed in most of the sensitivity analyses.
This is a single-center study, thus the extrapolation of the results may be limited.
Pregnant women with mental health symptoms, especially hostility, have an increased risk of PTB. The findings underscore that integrating mental health services into routine maternal care may be a strategy to prevent PTB.
早产 (PTB) 有多种风险因素，其中最重要的一个是孕期情绪障碍。我们旨在全面研究总心理健康问题和十种特定精神症状与 PTB 风险的关系。
本队列研究纳入了 2020 年至 2022 年期间在重庆医科大学附属妇女儿童医院就诊的 25175 名孕妇。采用症状清单 90（SCL-90）评估精神症状。应用多变量或多项逻辑回归分别调查与 PTB 风险或其不同临床亚类相关的心理健康问题。进一步进行敏感性分析以验证结果。
符合纳入标准的有 8336 名女性，其中 547 名（6.6%）发生早产，2542 名（30.5%）有心理健康问题。与心理健康的女性相比，总心理健康问题的女性 PTB 的总体风险增加 29.0%（OR=1.28，95%CI=1.07-1.54），医源性 PTB（OR=1.49，95%CI=1.05-2.13）和自发性 PTB 伴胎膜早破（OR=1.33，95%CI=1.01-1.74）。至于特定的心理症状，敌意孕妇 PTB 的风险增加 55.0%（OR=1.55，95%CI=1.14-2.11）。大多数敏感性分析中也观察到了类似的结果。
这是一项单中心研究，因此结果的外推可能有限。
有心理健康问题的孕妇，尤其是敌意，PTB 的风险增加。这些发现强调，将心理健康服务纳入常规产妇护理可能是预防 PTB 的一种策略。
