Miller Mikaela, Troyer Emily A, Gould Hilary M, Martinez Stephanie, Hong Suzi, Koh Steve, Kohn Jordan N
Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA.
Herbert Wertheim School of Public Health and Human Longevity Sciences, University of California San Diego, La Jolla, CA, 92093, USA.
Arch Womens Ment Health. 2025 Mar 31. doi: 10.1007/s00737-025-01579-w.
The objective of this study was to determine the independent effects of maternal mental health difficulties (MHD) during the preconception, prenatal, and postnatal periods on well-baby visit (WBV) attendance in a population-wide sample through retrospective analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data.
This secondary analysis utilized data from the 2016 - 2021 New Jersey PRAMS, yielding 6,699 participants (mean age = 30.8 years). Survey-weighted means, confidence intervals, and percentages were used to describe sociodemographic, mental health, and WBV variables across all participants. Logistic regression with complex survey weights and multiple imputation of missing data was implemented to test associations between sociodemographic factors, maternal MHDs, and WBV attendance.
The weighted prevalence of missing the 1-week checkup or having never attended a WBV during the first six months postpartum was 4.3% (95% CI: 3.8% - 5.0%; n = 260) and 1.4% (1.1% - 2.0%; n = 98), respectively. Preconception depression (n = 553; 7.7%, 7.0% - 8.0%), prenatal depression (n = 481; 6.5%, 5.9% - 7.0%;), preconception anxiety (n = 1,007; 15.2%, 14.2% - 16.0%), and prenatal anxiety (n = 570; 8.44%, 7.7% - 9.0%) were not associated with 1-week checkup attendance. However, women with preconception depression were more than twice as likely to have never attended a WBV (OR = 2.43, 1.01 - 5.82). Multiple social determinants and demographic variables were associated with greater odds of missing WBVs, including middle household income, receiving government-issued health insurance or being uninsured, Hispanic ethnicity, and Spanish as a primary language.
Preconception depression, middle household income, receiving government-issued health insurance, being uninsured, Hispanic ethnicity, and Spanish as a primary language may decrease attendance of WBVs, and the mediating role of preconception depression in infant health outcomes warrants further investigation.
本研究的目的是通过对妊娠风险评估监测系统（PRAMS）数据的回顾性分析，确定孕前、产前和产后期间孕产妇心理健康问题（MHD）对全人群样本中健康婴儿检查（WBV）出勤率的独立影响。
这项二次分析利用了2016 - 2021年新泽西州PRAMS的数据，共有6699名参与者（平均年龄 = 30.8岁）。使用调查加权均值、置信区间和百分比来描述所有参与者的社会人口统计学、心理健康和WBV变量。采用带有复杂调查权重和缺失数据多重插补的逻辑回归来检验社会人口统计学因素、孕产妇MHD与WBV出勤率之间的关联。
产后前六个月错过1周检查或从未参加过WBV的加权患病率分别为4.3%（95%CI：3.8% - 5.0%；n = 260）和1.4%（1.1% - 2.0%；n = 98）。孕前抑郁（n = 553；7.7%，7.0% - 8.0%）、产前抑郁（n = 481；6.5%，5.9% - 7.0%）、孕前焦虑（n = 1007；15.2%，14.2% - 16.0%）和产前焦虑（n = 570；8.44%，7.7% - 9.0%）与1周检查出勤率无关。然而，有孕前抑郁的女性从未参加过WBV的可能性是前者的两倍多（OR = 2.43，1.01 - 5.82）。多个社会决定因素和人口统计学变量与错过WBV的几率增加有关，包括中等家庭收入、接受政府发放的医疗保险或未参保、西班牙裔种族以及以西班牙语作为主要语言。
孕前抑郁、中等家庭收入、接受政府发放的医疗保险、未参保、西班牙裔种族以及以西班牙语作为主要语言可能会降低WBV的出勤率，孕前抑郁在婴儿健康结局中的中介作用值得进一步研究。
