基于倾向评分匹配法的辅助生殖妊娠抑郁发生情况研究

Study on the occurrence of depression in pregnant women with assisted reproductive technology based on propensity score matching method

目的探讨经辅助生殖技术(ART)妊娠孕产妇的抑郁发生情况。方法选取2019年8月至2022年2月期间分娩且于北京市朝阳区建档的孕产妇,以ART妊娠孕产妇为观察组,自然妊娠孕产妇为对照组。以年龄、工作、教育、民族及孕前身体质量指数作为配比条件,按照1:3的比例对观察组和对照组进行倾向评分匹配,最终纳入ART妊娠者497例,自然妊娠者1491例。采用Logistic回归分析ART妊娠者相比自然妊娠发生抑郁的风险。结果ART妊娠孕产妇孕早期、孕中期、孕晚期和产后抑郁的检出率为18.11%、4.43%、3.02%、3.42%,呈现逐渐降低趋势(χ^(2)_(趋势性)=76.440,P<0.05)。Logistic回归显示,在调整了生育史、流产史及心理保健服务机构等协变量的情况下,ART妊娠者相比自然妊娠发生抑郁风险的差异无统计学意义(OR=0.793,95%CI:0.616~1.021,P>0.05)。结论本研究未观察到ART妊娠增加抑郁发生的风险;经过孕产期心理保健,多数孕产妇的抑郁状态得到缓解。

Objective To investigate the occurrence of depression in pregnant women with assisted reproductive technology(ART).Methods The pregnant women who delivered between August 2019 and February 2022 and registered in Chaoyang District,Beijing were involved in the study.Pregnant women with ART pregnancy were selected as the observation group,and pregnant women with spontaneous pregnancy were selected as the control group.Taking age,work,education,ethnicity and pre-pregnancy body mass index as matching conditions,the observation group and the control group were matched with propensity score according to the ratio of 1:3.Finally,497 cases of ART pregnancy and 1491 cases of spontaneous pregnancy were included.Logistic regression was used to analyze the risk of depression in ART pregnancies compared with spontaneous pregnancies.Results The detection rates of depression of pregnant women with ART in the first trimester,second trimester,third trimester,and postpartum were 18.11%,4.43%,3.02%,and 3.42%,respectively,showing a gradual decreasing trend(χ~2=76.440,P<0.05).Logistic regression showed that after adjusting for covariates such as reproductive history,abortion history,and mental health care institutions,there was no statistically significant difference in the risk of depression between ART pregnancies and spontaneous pregnancies(OR=0.793,95%CI:0.616-1.021,P>0.05).Conclusion This study did not observe that ART pregnancy increases the risk of depression.After maternal mental health care,the depression state of most pregnant women is relieved.