Mizunuma Naoki, Yamada Keiko, Kimura Takashi, Ueda Yutaka, Takeda Takashi, Tabuchi Takahiro, Kurosaki Kunihiko
Department of Legal Medicine, Toho University Graduate School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan.
Tokyo Kagurazaka Law Office, Tokyo, Japan.
BMC Pregnancy Childbirth. 2024 Dec 26;24(1):860. doi: 10.1186/s12884-024-07082-x.
Unintended pregnancy at higher risk of perinatal mood disorders; however, concurrent factors such as socioeconomic conditions may be more critical to mental health than pregnancy intention. Mental health risks among individuals undergoing fertility treatment are inconsistent. We investigated mental health risks during pregnancy and parenthood in parents who conceived unintentionally or through fertility treatment compared to those who conceived naturally and intentionally.
We conducted a web-based study with 10,000 adults ≥ 18 years old, either pregnant or with a child aged < 2 years. Male and female respondents weren't couples. We analyzed 1711 men and 7265 women, after filtering out invalid responses. We used a questionnaire including conception methods (e.g., naturally conceived intended/unintended pregnancies, fertility treatment such as scheduled intercourse or ovulation inducers [SI/OI], intrauterine insemination [IUI], and in-vitro fertilization or intracytoplasmic sperm injection [IVF/ICSI]) and mental health risks (e.g., psychological distress, chronic pain, death fantasies). Using a modified Poisson regression, we estimated relative risks (RR [CI]) for mental health risks compared to those with intended pregnancies.
Unintended pregnancy showed higher mental health risks during pregnancy in both genders, with women having significantly higher psychological distress, chronic pain, and death fantasies (RR 1.63 [1.05-2.54], RR 1.63 [1.14-2.33], and RR 2.18 [1.50-3.18], respectively). Women's death fantasies risk remained high in parenthood: RR 1.40 (1.17-1.67). In relation to fertility treatments, men using SI/OI during their partner's pregnancy showed higher mental health risks, especially for chronic pain (RR 1.75 [1.01-3.05]). Men who underwent IUI showed higher mental health risks during parenthood, notably death fantasies (RR 2.41 [1.13-5.17]). Pregnant women using SI/OI experienced higher mental health risks, with a significant risk of chronic pain (RR 1.63 [1.14-2.33]). Pregnant women using IVF/ICSI had a significantly lower risk of chronic pain (RR 0.44 [0.22-0.87]), but women who used IVF/ICSI had a significantly higher risk of death fantasies during parenthood (RR 1.40 [1.04-1.88]).
Mental health risks vary by parenting stage (pregnancy or early parenthood) and gender, especially for those who conceived unintentionally or through fertility treatment. Both stages require adaptable mental health support for all parents.
N/A (non-interventional study).
意外怀孕会增加围产期情绪障碍的风险；然而，社会经济状况等并发因素对心理健康的影响可能比怀孕意愿更为关键。接受生育治疗的个体的心理健康风险并不一致。我们调查了意外怀孕或通过生育治疗受孕的父母在孕期及为人父母期间的心理健康风险，并与自然受孕且有生育意愿的父母进行了比较。
我们对10000名18岁及以上的成年人进行了一项基于网络的研究，这些人要么怀孕，要么孩子年龄小于2岁。男性和女性受访者并非夫妻关系。在过滤掉无效回复后，我们分析了1711名男性和7265名女性的数据。我们使用了一份问卷，其中包括受孕方式（例如自然受孕的有意/意外怀孕、生育治疗，如定时性交或促排卵剂[SI/OI]、宫内人工授精[IUI]以及体外受精或卵胞浆内单精子注射[IVF/ICSI]）和心理健康风险（例如心理困扰、慢性疼痛、死亡幻想）。通过修正的泊松回归分析，我们估计了与有生育意愿的怀孕者相比，心理健康风险的相对风险（RR[CI]）。
意外怀孕在孕期显示出更高的心理健康风险，男性和女性皆是如此，女性的心理困扰、慢性疼痛和死亡幻想显著更高（RR分别为1.63[1.05 - 2.54]、1.63[1.14 - 2.33]和2.18[1.50 - 3.18]）。女性在为人父母阶段死亡幻想风险仍然很高：RR为1.40（1.17 - 1.67）。关于生育治疗，伴侣怀孕时使用SI/OI的男性心理健康风险更高，尤其是慢性疼痛方面（RR为1.75[1.01 - 3.05]）。接受IUI的男性在为人父母期间心理健康风险更高，尤其是死亡幻想方面（RR为2.41[1.13 - 5.17]）。使用SI/OI的孕妇心理健康风险更高，慢性疼痛风险显著（RR为1.63[1.14 - 2.33]）。使用IVF/ICSI的孕妇慢性疼痛风险显著更低（RR为0.44[0.22 - 0.87]），但使用IVF/ICSI的女性在为人父母期间死亡幻想风险显著更高（RR为1.40[1.04 - 1.88]）。
心理健康风险因为人父母的阶段（孕期或为人父母早期）和性别而异，尤其是对于那些意外怀孕或通过生育治疗受孕的人。这两个阶段都需要为所有父母提供适应性的心理健康支持。
无（非干预性研究）。
