怀孕前压力生活事件和围产期心理健康障碍从怀孕到分娩后三年：一项观察性研究。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine Pub Date : 2025-08-08 DOI:10.1016/j.amepre.2025.108039

Songtao Wu BMed , Yue Zhang BMed , Hui Wang MMed , Jiyue Dai BMed , Weijie Ding MMed , Xiaoqin Zhu BMed , Xiaolin Xu PhD

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引用次数: 0

摘要

孕前应激性生活事件（SLEs）与围产期心理健康障碍在多个时间点的关系尚不完全清楚。本研究旨在评估孕前SLEs与妊娠至分娩后3年孕产妇精神健康障碍发生率的关系。方法：这项回顾性队列研究纳入了2020年7月至2021年6月在中国淮安分娩的1994名妇女，基于祖母、母亲和她们的孩子的健康研究。参与者在怀孕前一年的SLEs包括与伴侣和家庭成员的冲突；虐待：身体、性或精神上的虐待；亲友死亡；还有财政压力。在怀孕期间以及分娩后1年和3年确定产妇精神健康障碍（包括焦虑和抑郁）。采用改进的泊松回归模型评估相关性，并采用Shapley方法估计特定压力源的相对贡献。数据收集于2020-2023年，分析于2024年7月- 2025年2月。结果：共有602名（30.2%）参与者经历了孕前SLEs；分别有494名（24.8%）、432名（21.7%）和240名（12.0%）参与者在怀孕期间、分娩后一年和三年内接受了精神健康障碍筛查。孕前SLEs与孕期、产后1年和产后3年产妇精神健康障碍风险分别增加2.20倍（95%可信区间[CI]: 1.90-2.56）、2.07倍（1.76-2.43）和2.98倍（2.34-3.79）相关。这种关联在共病性焦虑和抑郁以及持续性产妇精神健康障碍中更为明显。经济压力和家庭冲突是孕产妇围产期心理健康障碍的主要原因。结论：孕前SLEs与孕期至产后3年的产妇心理健康障碍相关。经济压力和家庭冲突是造成这些关联的主要原因。这些发现强调了在怀孕期间和分娩后几年持续进行心理健康监测的重要性，特别是对于那些经历过SLEs的人。

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Prepregnancy Stressful Life Events and Perinatal Mental Health Disorders From Pregnancy to 3 Years After Childbirth: An Observational Study

Introduction

The associations of prepregnancy stressful life events with perinatal mental health disorders at multiple time points are not fully understood. This study aims to assess the associations of prepregnancy stressful life events with occurrences of maternal mental health disorders from pregnancy to 3 years after childbirth.

Methods

This retrospective cohort study included 1,994 women who had experienced childbirth from July 2020 to June 2021 in Huai’an, China, on the basis of the Grandmothers, Mothers, and Their Children’s Health study. Participants’ stressful life events 1 year before pregnancy included conflict with partners and family members; physical, sexual, or emotional abuse; deaths of friends or relatives; and financial stress. Maternal mental health disorders (including anxiety and depression) were determined during pregnancy and 1 year and 3 years after childbirth. Modified Poisson regression models were used to assess the associations, and the Shapley method was used to estimate the relative contributions of specific stressors. Data were collected during 2020–2023 and were analyzed during July 2024–February 2025.

Results

A total of 602 (30.2%) participants experienced prepregnancy stressful life events; 494 (24.8%), 432 (21.7%), and 240 (12.0%) participants were screened for mental health disorders during pregnancy, 1 year after childbirth, and 3 years after childbirth, respectively. Prepregnancy stressful life events were associated with 2.20-fold (95% CI=1.90, 2.56), 2.07-fold (95% CI=1.76, 2.43), and 2.98-fold (95% CI=2.34, 3.79) increased risks of maternal mental health disorders during pregnancy, 1 year after childbirth, and 3 years after childbirth, respectively. The associations were more evident for comorbid anxiety and depression as well as for persistent maternal mental health disorders. Financial stress and family conflicts were primary contributors to perinatal maternal mental health disorders.

Conclusions

Prepregnancy stressful life events were associated with maternal mental health disorders from pregnancy to 3 years after childbirth. Financial stress and family conflicts were primary contributors to these associations. These findings highlight the importance of consistent mental health monitoring during pregnancy and during the years after childbirth, particularly among those who experience stressful life events.

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来源期刊

American Journal of Preventive Medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.60

自引率

1.80%

发文量

395

审稿时长

32 days

期刊介绍： The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.