孕前孕产妇心理健康相关住院治疗(MHrH)与孕期结果之间的关系:澳大利亚北领地基于人口的队列研究

IF 3.2 3区 医学 Q2 PSYCHIATRY
Abel F. Dadi, Vincent He, Rosa Alati, Karen Hazell-Raine, Philip Hazell, Kiarna Brown, Steven Guthridge
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引用次数: 0

摘要

在澳大利亚,很少有全面的研究调查孕产妇在怀孕前因精神健康状况住院与妊娠期不良后果之间的联系。我们旨在利用 18 年的行政关联数据来填补这一空白,为早期干预提供依据。我们将 1999 年至 2017 年的围产期数据与住院数据相链接,建立了一个在北部地区(NT)分娩的 15 至 44 岁孕妇队列。我们使用《国际疾病分类》第 10 次修订版(ICD-AM-10)代码来查找精神健康相关住院(MHrH)(感兴趣的暴露)的妇女,并使用围产期数据来获取妊娠结果。我们使用修正的泊松回归法和稳健的标准误差来估算孕前 5 年与孕产妇精神健康相关住院有关的妊娠结局风险。我们计算了有效关联的调整后人群可归因分数(aPAF)。我们使用 E 值来评估潜在混杂偏差的影响。在 69,890 例妊娠中,约有 67,518 例符合条件并被纳入分析。我们发现,原住民妇女和非原住民妇女之间,以及怀孕前 5 年患有和未患有 MHrH 的妇女之间,在药物使用和并发症的发生率方面存在明显差异。经调整后,原住民妇女孕前5年因药物滥用住院与宫内发育受限(IUGR)风险增加31%(95%CI,1.05,1.63)、吸烟风险增加60%(CI,1.37,1.86)和孕期饮酒风险增加2.21(CI,1.98,2.47)倍相关;非原住民妇女孕期饮酒风险增加17%(CI,1.11,1.23)。很大比例的吸烟(aPAF = 14.7% 至 37.4%)、饮酒(aPAF = 46.0% 至 66.7%)和 IUGR(aPAF = 23.6% 至 38.5%)是由于孕前 5 年的产妇 MHrH 引起的。我们的研究结果为加强孕前保健以减少孕前产妇 MHrH 的不良后果敲响了 "警钟"。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Association Between Preconception Maternal Mental Health-Related Hospitalisation (MHrH) and Outcomes During Pregnancy: A Population-Based Cohort Study in the Northern Territory, Australia

Association Between Preconception Maternal Mental Health-Related Hospitalisation (MHrH) and Outcomes During Pregnancy: A Population-Based Cohort Study in the Northern Territory, Australia

Comprehensive studies investigating the link between maternal hospitalisation for mental health conditions prior to pregnancy and adverse outcomes in pregnancy are scarce in Australia. We aimed to fill this gap by using 18 years of administratively linked data to inform early interventions. We linked the perinatal data from the year 1999 to 2017 to the hospital hospitalisation data to create a cohort of pregnant women aged 15 to 44 years who gave birth in the Northern Territory (NT). We used the International Classification of Disease 10th revision (ICD-AM-10) codes to locate women with mental health-related hospitalisation (MHrH) (exposure of interest) and the perinatal data to access pregnancy outcomes. We used the modified Poisson regression with robust standard error to estimate the risk of pregnancy outcomes associated with maternal MHrH in the 5 years prior to pregnancy. We calculated the adjusted population attributable fraction (aPAF) for valid associations. We used the E-value to assess the effect of potential confounding bias. Out of 69,890 pregnancies, ~ 67,518 were eligible and included in the analysis. We found a significant variation in the incidence of substance use and complications between Aboriginal and non-Aboriginal women and women with and without MHrH in the 5 years prior to pregnancy. After adjusting, 5 years of preconception hospitalisation for substance misuse was associated with a 31% (95%CI, 1.05, 1.63) increased risk of Intrauterine Growth Restriction (IUGR), a 60% (CI, 1.37, 1.86) increased risk of smoking and a 2.21 (CI, 1.98, 2.47) times increased risk of drinking during pregnancy in Aboriginal women; and a 17% increased risk of drinking (CI, 1.11, 1.23) in pregnancy in non-Aboriginal women. A significant proportion of smoking (aPAF = 14.7 to 37.4%), alcohol consumption (aPAF = 46.0 to 66.7%), and IUGR (aPAF = 23.6 to 38.5%) are attributed to maternal MHrH 5 years prior to pregnancy. Our findings are a ‘wake-up’ call for strengthening preconception care to reduce adverse outcomes of maternal MHrH prior to pregnancy.

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来源期刊
CiteScore
15.90
自引率
2.50%
发文量
245
审稿时长
6-12 weeks
期刊介绍: The International Journal of Mental Health and Addictions (IJMH) is a publication that specializes in presenting the latest research, policies, causes, literature reviews, prevention, and treatment of mental health and addiction-related topics. It focuses on mental health, substance addictions, behavioral addictions, as well as concurrent mental health and addictive disorders. By publishing peer-reviewed articles of high quality, the journal aims to spark an international discussion on issues related to mental health and addiction and to offer valuable insights into how these conditions impact individuals, families, and societies. The journal covers a wide range of fields, including psychology, sociology, anthropology, criminology, public health, psychiatry, history, and law. It publishes various types of articles, including feature articles, review articles, clinical notes, research notes, letters to the editor, and commentaries. The journal is published six times a year.
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