Smith Holly Christina, Archer Charlotte, Bailey James, Chew Graham Carolyn, Evans Jonathan, Fisher Tamsin, Kessler David, Kingstone Tom, Procter Janine, Shivji Noureen, Silverwood Victoria, Spruce Amy, Turner Katrina, Wu Pensée, Yu Dahai, Petersen Irene
Department of Primary Care and Population Health, University College London, London, UK
Population Health Sciences, University of Bristol Medical School, Bristol, UK.
BMJ Ment Health. 2025 Jan 9;28(1):e301160. doi: 10.1136/bmjment-2024-301160.
There is some evidence that perinatal anxiety (PNA) is associated with lower rates of infant vaccinations and decreased access to preventative infant healthcare, but results across studies have not been conclusive.
To investigate the relationship between maternal PNA and infant primary care use.
Cohort study of mother-infant pairs identified between 1998 and 2016 using IQVIA Medical Research Database (IMRD). PNA was identified through prescription, diagnosis and symptom records from start of pregnancy up to 1 year after birth. Outcomes include primary care consultation rate, attendance at the 6-8 week infant check and uptake of the infant 5-in-1 vaccination, comparing unadjusted rates of consultations and using logistic regression to analyse other outcomes.
Of the 248 618 women, 11 558 (4.7%) had a record of PNA. Infants of mothers with PNA had, on average, one more primary care consultation/person-year compared with those without (9.7 vs 8.7) in the year after birth. Mothers with PNA were more likely to have an infant who was vaccinated (adjusted OR (aOR) 1.33, 95% CI 1.20 to 1.48) but were less likely to have a record of attendance at the 6-8 week infant check (aOR 0.88, 95% CI 0.81 to 0.95).
Infants of mothers with PNA had, on average, a slightly higher rate of primary care consultations and were more likely to be vaccinated but less likely to have a record of an infant check.
Midwives and General Practitioners (GPs) providing care should consider how PNA may impact on infant health and how infant health may impact on maternal anxiety.
有证据表明围产期焦虑（PNA）与婴儿疫苗接种率较低以及获得预防性婴儿医疗保健的机会减少有关，但各研究结果尚无定论。
调查母亲围产期焦虑与婴儿初级保健利用之间的关系。
利用IQVIA医学研究数据库（IMRD）对1998年至2016年间确定的母婴对进行队列研究。通过从怀孕开始到出生后1年的处方、诊断和症状记录来确定围产期焦虑。结果包括初级保健咨询率、6 - 8周婴儿检查的出勤率以及婴儿五联疫苗的接种率，比较未经调整的咨询率，并使用逻辑回归分析其他结果。
在248618名女性中，11558名（4.7%）有围产期焦虑记录。围产期焦虑母亲的婴儿在出生后一年中，平均每人每年的初级保健咨询次数比无围产期焦虑母亲的婴儿多一次（9.7次对8.7次）。有围产期焦虑的母亲所生婴儿接种疫苗的可能性更大（调整后的比值比（aOR）为1.33，95%置信区间为1.20至1.48），但在6 - 8周婴儿检查中有出勤记录的可能性较小（aOR为0.88，95%置信区间为0.81至0.95）。
围产期焦虑母亲的婴儿平均初级保健咨询率略高，接种疫苗的可能性更大，但婴儿检查记录的可能性较小。
提供护理的助产士和全科医生应考虑围产期焦虑如何影响婴儿健康以及婴儿健康如何影响母亲焦虑。
