孕期抑郁对早产和低出生体质量影响的辅助生殖队列研究

Effect of maternal depression in assisted reproductive techonology on offspring's premature delivery and low birth weight

目的探讨接受辅助生殖治疗的母亲孕期抑郁与子代早产和低出生体质量的关系。方法运用回顾性队列研究分析2017年5月至2020年12月期间在安徽医科大学第一附属医院妇产科生殖中心行辅助生殖治疗且成功分娩的不孕患者单胎妊娠病历资料,共376例。采用二元logistic回归分析模型,分别分析孕前、早、中、晚期抑郁及孕期新发抑郁与子代早产和低出生体质量之间的关联。结果孕前、早、中、晚的抑郁检出率分别为20.0%(75/376)、23.0%(83/363)、11.2%(41/366)、8.8%(31/354)。孕前、早、中期抑郁与早产之间的关联均无统计学意义(均P>0.05);孕晚期抑郁(RR=2.18,95%CI=1.02~4.65,P=0.040)及孕期新发抑郁(RR=2.03,95%CI=1.01~4.05,P=0.046)与发生子代早产的风险呈正相关。孕前、早、中、晚期抑郁及孕期新发抑郁与低出生体质量之间的关联均无统计学意义(均P>0.05)。结论辅助生殖助孕患者孕晚期抑郁及孕期新发抑郁可能是导致早产的重要危险因素,但孕期抑郁与发生低出生体质量的风险无显著关联。

Objective To evaluate the relationship between antenatal depression in mothers who received assisted reproductive techonology(ART)and premature birth and low birth weight.Methods In this retrospective cohort study,376 infertile women who successfully delivered single-child were recruited at the Reproductive Center,Department of Obstetrics and Gynecology of the First Affiliated Hospital of Anhui Medical University from May 2017 to December 2020.Binary logistic regression analysis model was used to analyze the association between pre-pregnancy depression,depression in the first,second and third trimesters and new onset depression during pregnancy with preterm delivery and low birth weight.Results The detection rates of depression before pregnancy,in the first,second and third trimesters of pregnancy were 20.0%(75/376),23.0%(83/363),11.2%(41/366),8.8%(31/354),respectively.There was no statistically significant association between depression in the pre-pregnancy,the first trimester and the second trimester and preterm delivery(all P>0.05).Depression in the third trimester(RR=2.18,95%CI=1.02-4.65,P=0.040)and new onset depression during pregnancy(RR=2.03,95%CI=1.01-4.05,P=0.046)were positively correlated with preterm delivery.The associations between pre-pregnancy depression,depression in the first,second and third trimesters,and new onset depression and low birth weight were not statistically significant(all P>0.05).Conclusion Antenatal depression in the third trimester and new onset depression during pregnancy may be important risk factors for premature delivery,but there is no significant association between antenatal depression and low birth weight.