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怀孕前心脏状况影响产后情绪和焦虑障碍的风险

Shirley J Shao¹, Lucy J Fu², John Boscardin³

¹School of Medicine, University of California San Francisco, San Francisco, CA, USA.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

|August 21, 2025

概括

产后心脏病并没有独立增加产后情绪和焦虑障碍 (PPMADs) 的风险. 然而,心脏状况不佳,社会史和妊娠并发症等因素与PPMAD风险较高有关.

科学领域:

心脏病学
妇产科
精神病学
母亲健康

背景情况:

产后情绪和焦虑障碍 (PPMAD) 是影响母亲健康的重要问题.
预先存在的母亲心脏病作为PPMAD的独立风险因素的作用需要进一步调查.
了解风险因素对于有针对性的干预和改善围产期精神卫生保健至关重要.

研究的目的:

确定孕产妇心脏病是否是产后情绪和焦虑障碍 (PPMAD) 的独立危险因素.
评估心脏风险得分较高与发展PPMADs风险之间的关联.
确定有助于孕妇患PPMAD风险的特定心脏和非心脏因素.

主要方法:

在2019年6月至2024年2月期间进行了回顾性匹配队列研究.
患者完成了PPMAD查,使用患者健康问卷-9 (PHQ-9) 或一般焦虑障碍-7 (GAD-7) 评分 (≥10表示阳性查).
用双项回归计算了阳性PPMAD查的相对风险 (RRs),将心脏分娩团队管理的心脏队列与匹配的非心脏队列进行比较.

主要成果:

在心脏队列中,阳性PPMAD查的流行率为18. 2%,在非心脏队列中为16. 2%.
单独的孕产妇心脏病并不是PPMADs的独立风险因素 (RR 1. 13,95% CI 0. 68- 1. 86).
增加的PPMAD风险与纽约心脏协会≥II级 (RR 3. 12),怀孕前使用尿剂 (RR 2. 98),社会经济劣势,意外怀孕,抗抑郁药使用史,人际暴力史和不良怀孕结果 (高血压疾病,产周输血,早产) 相关.

结论:

单独的孕产妇心脏病不会独立地增加产后情绪和焦虑障碍的风险.
诸如心脏状况不佳,社会病史不良以及怀孕期间的并发症等因素显著增加了PPMAD的风险.
早期优化心脏健康和提供全面的产前护理对于减轻心脏病患者的PPMAD风险至关重要.

关键词:

怀孕期间的心脏病母亲心脏病周围生育期情绪障碍产后焦虑症产后抑郁症

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