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孕产妇精神障碍与新生儿结局:丹麦基于人群的队列研究。

Maternal mental disorders and neonatal outcomes: Danish population-based cohort study.

作者信息

Momen Natalie C, Chatwin Hannah, Holde Katrine, Liu Xiaoqin, Munk-Olsen Trine, Madsen Kathrine Bang, Petersen Liselotte Vogdrup

机构信息

National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.

National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; and Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

出版信息

Br J Psychiatry. 2025 Jan;226(1):31-38. doi: 10.1192/bjp.2024.164.

Abstract

BACKGROUND

Previous studies have indicated associations between maternal mental disorders and adverse birth outcomes; however, these studies mainly focus on certain types of mental disorders, rather than the whole spectrum.

AIMS

We aimed to conduct a broad study examining all maternal mental disorder types and adverse neonatal outcomes which is needed to provide a more complete understanding of the associations.

METHOD

We included 1 132 757 liveborn singletons born between 1997 and 2015 in Denmark. We compared children of mothers with a past (>2 years prior to conception; = 48 646), recent (2 years prior to conception and during pregnancy; = 15 899) or persistent (both past and recent; 10 905) diagnosis of any mental disorder, with children of mothers with no mental disorder diagnosis before the index delivery ( = 1 057 307). We also considered different types of mental disorders. We calculated odds ratios and 95% CIs of low birthweight, preterm birth, small for gestational age, low Apgar score, Caesarean delivery and neonatal death.

RESULTS

Odds ratios for children exposed to past, recent and persistent maternal mental disorders suggested an increased risk for almost all adverse neonatal outcomes. Estimates were highest for children in the 'persistent' group for all outcomes, with the exception of the association between persistent maternal mental disorders and neonatal death (odds ratio 0.96, 0.62-1.48).

CONCLUSIONS

Our study provides evidence for increased risk of multiple adverse neonatal outcomes among children of mothers with mental disorders, highlighting the need for close monitoring and support for women with mental disorders.

摘要

背景

先前的研究表明,孕产妇精神障碍与不良分娩结局之间存在关联;然而,这些研究主要关注某些类型的精神障碍,而非整个范围。

目的

我们旨在进行一项广泛的研究,考察所有孕产妇精神障碍类型及不良新生儿结局,以更全面地了解这些关联。

方法

我们纳入了1997年至2015年在丹麦出生的1132757名单胎活产儿。我们将有既往(受孕前>2年;n = 48646)、近期(受孕前2年及孕期;n = 15899)或持续(既往和近期均有;n = 10905)任何精神障碍诊断的母亲所生子女,与在本次分娩前无精神障碍诊断的母亲所生子女(n = 1057307)进行比较。我们还考虑了不同类型的精神障碍。我们计算了低出生体重、早产、小于胎龄儿、低阿氏评分、剖宫产和新生儿死亡的比值比及95%置信区间。

结果

暴露于既往、近期和持续孕产妇精神障碍的儿童的比值比表明,几乎所有不良新生儿结局的风险均增加。除持续孕产妇精神障碍与新生儿死亡之间的关联外(比值比0.96,0.62 - 1.48),所有结局中“持续”组儿童的估计值最高。

结论

我们的研究为患有精神障碍的母亲所生子女出现多种不良新生儿结局的风险增加提供了证据,强调了对患有精神障碍的女性进行密切监测和支持的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a628/11781859/e38e50a36f12/S0007125024001648_fig1.jpg

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