Hedegaard M, Henriksen T B, Sabroe S, Secher N J
Department of Obstetrics and Gynaecology, Aarhus University Hospital, Denmark.
BMJ. 1993 Jul 24;307(6898):234-9. doi: 10.1136/bmj.307.6898.234.
To investigate if psychological distress during pregnancy is associated with increased risk of preterm delivery.
Prospective, population based, follow up study with repeated measures of psychological distress (general health questionnaire), based on the use of questionnaires.
Antenatal care clinic and delivery ward, Aarhus University Hospital, Denmark.
8719 women with singleton pregnancies attending antenatal care for the initial visit between 1 August 1989 and 30 September 1991; 5872 women (67%) completed all questionnaires.
Preterm delivery. Estimation of gestational age at delivery was mainly based on early ultrasound measurements.
In 197 cases (3.6%) the woman delivered prematurely (less than 259 days). A dose-response relation between psychological distress in the 30th week of pregnancy and risk of preterm delivery was found, but distress measured in the 16th week was not related to preterm delivery. Control of confounding was secured by the use of multivariate logistic regression models. Relative risk for preterm delivery was 1.22 (95% confidence interval 0.84 to 1.79) for moderate distress and 1.75 (1.20 to 2.54) for high distress in comparison to low distress.
Psychological distress later in pregnancy is associated with an increased risk of preterm delivery. Future interventional studies should focus on ways of lowering psychological distress in late pregnancy.
探讨孕期心理困扰是否与早产风险增加有关。
基于问卷调查的前瞻性、人群为基础的随访研究，对心理困扰（一般健康问卷）进行重复测量。
丹麦奥胡斯大学医院的产前保健诊所和分娩病房。
1989年8月1日至1991年9月30日期间首次到产前保健门诊就诊的8719名单胎妊娠妇女；5872名妇女（67%）完成了所有问卷。
早产。分娩时孕周的估计主要基于早期超声测量。
197例（3.6%）妇女早产（少于259天）。发现妊娠第30周时的心理困扰与早产风险之间存在剂量反应关系，但第16周时测量的困扰与早产无关。通过使用多因素逻辑回归模型确保了混杂因素的控制。与低困扰相比，中度困扰的早产相对风险为1.22（95%置信区间0.84至1.79），高度困扰为1.75（1.20至2.54）。
孕期后期的心理困扰与早产风险增加有关。未来的干预研究应侧重于降低妊娠后期心理困扰的方法。
