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成为母亲会让你生病吗?——基于BARMER计费数据比较产后母亲与未育女性心理健康诊断的频率

[Does becoming a mother make you ill?-Frequency of mental health diagnoses in postpartum mothers compared to childless women based on BARMER billing data].

作者信息

Hertle Dagmar, Petrautzki Isabelle, Wende Danny

机构信息

BARMER Institut für Gesundheitssystemforschung, bifg, Lichtscheider Str. 89, 42285, Wuppertal, NRW, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 Dec;67(12):1325-1333. doi: 10.1007/s00103-024-03969-4. Epub 2024 Nov 17.

Abstract

INTRODUCTION

Around 700,000 children are born in Germany every year. Many mothers are under great pressure and strain due to prevailing role models and social expectations. Up to 15% of mothers in Germany are said to be affected by postpartum depression. The available studies, however, are mainly based on surveys, are older and vary widely in their results. This study brings another data source into play and asks how frequently diagnoses of mental illness are found in mothers after childbirth compared to childless women in the billing data of a large health insurance company.

METHODS

A retrospective matched cohort study was conducted with health insurance data from 2017-2022, comparing mothers and childless women with the same age and the same medical and socioeconomic characteristics with regard to depression, exhaustion and burnout, and anxiety and stress disorder outcomes. The modelling was carried out using Poisson regression.

RESULTS

Mothers were less likely than childless women to receive a diagnosis of a mental disorder within five years after childbirth. In the long run, however, the frequency of diagnoses equalised.

DISCUSSION

Becoming a mother does not lead to more diagnoses of mental disorders compared to childless women, at least in the first five years after giving birth. However, the interpretation of the data is difficult. Possible influence of external factors on making the diagnosis is not seen in the data, such as the social expectation of a "happy mother" or a change in the utilisation of medical care due to maternity.

摘要

引言

德国每年约有70万儿童出生。由于普遍的榜样作用和社会期望,许多母亲承受着巨大的压力和负担。据说德国高达15%的母亲受到产后抑郁症的影响。然而,现有的研究主要基于调查,时间较久且结果差异很大。本研究引入了另一个数据源,并探讨了在一家大型健康保险公司的计费数据中,与未育女性相比,产后母亲被诊断出精神疾病的频率有多高。

方法

利用2017年至2022年的健康保险数据进行了一项回顾性匹配队列研究,比较了年龄、医疗和社会经济特征相同的母亲和未育女性在抑郁、疲惫、倦怠以及焦虑和应激障碍方面的结果。采用泊松回归进行建模。

结果

产后五年内,母亲被诊断出精神障碍的可能性低于未育女性。然而,从长远来看,诊断频率趋于相等。

讨论

与未育女性相比,成为母亲并不会导致更多的精神障碍诊断,至少在产后的头五年是这样。然而,数据的解读很困难。数据中未体现外部因素对诊断的可能影响,比如“幸福母亲”的社会期望,或者由于生育导致的医疗保健利用情况的变化。

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