Munshi Sushma C, Hoex Eline C I, Weggelaar-Jansen Anne Marie, Knijff Esther M, van der Wilk Eline C, Steegers Eric A P, Bijma Hilmar H
Erasmus MC - Sophia Children's Hospital, Department Obstetrics and Gynaecology, Division Obstetrics and Fetal Medicine, University Medical Centre Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, South Holland, The Netherlands.
Tranzo, Tilburg University, Reitse Poort 1, 5000 LE, Tilburg, The Netherlands.
Arch Womens Ment Health. 2025 Jan 17. doi: 10.1007/s00737-024-01554-x.
Psychosocial risk factors are frequently present in pregnant women and are associated with adverse maternal and neonatal outcomes. Professional guidelines recommend early detection of vulnerability and provision of multidisciplinary care, including an integrated care plan for pregnant women with social factors, such as residing in deprived areas, teenage pregnancy, and psychiatric illness. However, to date, such approach is impeded by lack of data on co-occurrence of vulnerability. Therefore, we aim to describe co-occurrence of psychiatric illness, social factors or substance use during pregnancy.
A retrospective cohort study of 1002 pregnant women referred for evaluation by a multidisciplinary team because of psychiatric illness, social factors or substance use in a university hospital in a large city in the Netherlands. Data from medical charts between January 2017 and May 2022 were extracted and analyzed by univariate and bivariate analysis.
Multi-domain vulnerability was present in 83% of women and most frequently involved the following patterns: psychiatric illness with social factors and chronic physical illness (24%), psychiatric illness with social factors (14%), social factors with chronic physical illness (13%) and psychiatric illness with chronic physical illness (12%). Single-domain vulnerability was present in 17% of women, involving most frequently social factors (9%) and psychiatric illness (8%).
The majority of women with psychiatric illness, social factors or substance use have multi-domain vulnerability. There is a need for a novel approach to care to address vulnerability in pregnant women.
心理社会风险因素在孕妇中经常存在，并与不良的孕产妇和新生儿结局相关。专业指南建议早期发现脆弱性并提供多学科护理，包括为有社会因素的孕妇制定综合护理计划，如居住在贫困地区、青少年怀孕和精神疾病。然而，迄今为止，这种方法因缺乏关于脆弱性共现的数据而受到阻碍。因此，我们旨在描述孕期精神疾病、社会因素或物质使用的共现情况。
对荷兰一个大城市的一家大学医院中因精神疾病、社会因素或物质使用而被多学科团队转诊进行评估的1002名孕妇进行回顾性队列研究。提取2017年1月至2022年5月期间病历中的数据，并通过单变量和双变量分析进行分析。
83%的女性存在多领域脆弱性，最常见的模式如下：精神疾病伴社会因素和慢性躯体疾病（24%）、精神疾病伴社会因素（14%）、社会因素伴慢性躯体疾病（13%）以及精神疾病伴慢性躯体疾病（12%）。17%的女性存在单领域脆弱性，最常见的是社会因素（9%）和精神疾病（8%）。
大多数患有精神疾病、社会因素或物质使用问题的女性存在多领域脆弱性。需要一种新的护理方法来解决孕妇的脆弱性问题。
