胎儿手术对产妇心理健康的影响[j]

A. Larish, Hannah K. Betcher, O. Liseth, K. Moore, M. Schenone, Jessica Weng
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引用次数: 0

摘要

围产期精神疾病是一项重大的健康负担。许多因素被推测会增加胎儿手术人群围产期情绪和焦虑障碍(PMADs)的发生率,包括不确定的胎儿预后以及手术和早产的固有风险。我们试图确定胎儿手术人群中pmad的病程。方法:回顾性分析2017年至2021年在某三级保健中心进行胎儿手术的患者。记录了人口统计学、外科、产科和精神病学诊断。进行标准描述性分析。结果:确定了119例符合条件的患者。胎儿手术中位胎龄为23.0(16.0-34.0)周。激光消融胎盘吻合口(51例)和子宫内髓膜脊膜膨出修复(22例)是最常见的手术。26.8%(32/119)的患者术前存在情绪障碍,分别有59.3%(19/32)和53.1%(17/32)的患者在手术前服用了治疗抑郁或焦虑的基线药物。26.4%(23/87)无焦虑或抑郁史的患者新诊断为PMAD。两名患者产生了自杀念头。6.7%(8/119)和10.1%(12/119)分别在怀孕期间或怀孕后开始使用新的精神科药物。19.8%(21/113)接受过治疗转诊。在基线焦虑或抑郁患者中,62.5%(20/32)的患者产后加重,其中25.0%(8/32)的患者转诊治疗,34.3%(11/32)的患者因焦虑而改变剂量或药物,37.5%(12/32)的患者因抑郁而改变剂量或药物。结论:在接受胎儿手术的患者中,PMAD的发病率很高。大多数孕前焦虑或抑郁患者在产后会加重。有必要进一步研究有效的支持性干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Fetal Surgery on Maternal Mental Health [ID: 1376946]
INTRODUCTION: Perinatal mental illness imparts a significant health burden. A multitude of factors are hypothesized to increase the incidence of perinatal mood and anxiety disorders (PMADs) in the fetal surgical population, including uncertain fetal prognosis and the inherent risks of surgery and preterm delivery. We sought to determine the disease course of PMADs in the fetal surgery population. METHODS: A retrospective chart review was conducted of fetal surgery patients from 2017 to 2021 at a tertiary care center. Demographics, surgical, obstetric, and psychiatric diagnoses were recorded. Standard descriptive analyses were performed. RESULTS: One hundred nineteen eligible patients were identified. Fetal surgery was performed at a median gestational age of 23.0 (range 16.0–34.0) weeks. Laser ablation of placental anastomoses (n=51) and in utero myelomeningocele repair (n=22) were the most common procedures. 26.8% (32/119) had preexisting mood disorders, with 59.3% (19/32) and 53.1% (17/32) on a baseline medication for depression or anxiety, respectively, prior to surgery. 26.4% (23/87) of patients without a history of anxiety or depression had a new diagnosis of PMAD. Two patients experienced suicidal ideation. 6.7% (8/119) and 10.1% (12/119) initiated a new psychiatric medication during or post-pregnancy, respectively. 19.8% (21/113) received a therapy referral. Among patients with baseline anxiety or depression, 62.5% (20/32) experienced an exacerbation postpartum with 25.0% (8/32) referred for therapy, and 34.3% (11/32) changing dose or medication for anxiety and 37.5% (12/32) for depression. CONCLUSION: Among patients undergoing fetal surgery, a high incidence of PMAD was identified. Most patients with prepregnancy anxiety or depression experienced an exacerbation postpartum. Further research into effective supportive interventions is warranted.
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