A new perspective on the causal pathway between maternal mental health and neonatal adversity.

IF 3.2 3区医学 Q2 PSYCHIATRY Archives of Women's Mental Health Pub Date : 2024-12-04 DOI:10.1007/s00737-024-01541-2

Emma Lin, Elah Wilson, Arad Kodesh, Stephen Z Levine, Abraham Reichenberg, Nathan Fox, Nina Zaks, Magdalena Janecka

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Abstract

Purpose: Substantial evidence suggests a downstream impact of maternal mental health on birth outcomes. The roles of comorbid maternal physical health and familial confounding underlying this association remain unclear.

Methods: This cohort study included a random sample of children born 1997-2008 within a health maintenance organization (HMO) in Israel, their parents, and siblings. Outcomes were ICD-9 diagnoses of neonatal adversities (birth complications and congenital anomalies) and exposures were maternal diagnoses of mental health disorders. Odds ratios (ORs) and their 95% confidence intervals for the associations between maternal mental health diagnoses and measures of neonatal adversity were calculated using logistic regression, adjusting for maternal age, child's year of birth, socioeconomic status, and maternal physical morbidity burden. We examined potential familial confounding using a negative control approach based on paternal exposure.

Results: In our sample of 74,533 children, 6,674 (9.1%) were born after birth complications and 14,569 (19.9%) with a congenital anomaly. Maternal mental health diagnosis around pregnancy was significantly associated with these measures of neonatal adversity after adjustment for potential confounders (birth complications: OR = 1.3 (1.2-1.4), p < 0.001; congenital anomalies: OR = 1.2 (1.1-1.3), p < 0.001). These associations became attenuated and non-significant after further adjustment for maternal physical morbidity burden. In a joint model, maternal and paternal diagnosis of a mental health disorder were independently associated with neonatal adversity (birth complications: OR_mat=1.3 (1.1-1.4), p < 0.001; OR_pat=1.2 (1.1-1.3), p = 0.004; congenital anomalies: OR_mat=1.2 (1.1-1.3), p < 0.001; OR_pat=1.1 (1.0-1.2), p = 0.01).

Conclusion: Physical health and familial factors play a role in the associations between maternal mental health and neonatal adversity.

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产妇心理健康与新生儿逆境因果关系的新视角

目的：大量证据表明，产妇心理健康对分娩结果有下游影响。合并症产妇身体健康和家族混杂因素在这种关联中的作用尚不清楚。方法：本队列研究纳入了以色列一家健康维护组织（HMO） 1997-2008年出生的儿童及其父母和兄弟姐妹的随机样本。结果是ICD-9诊断出新生儿逆境（出生并发症和先天性异常），暴露是母亲诊断出精神健康障碍。使用逻辑回归计算了产妇心理健康诊断与新生儿逆境测量之间的比值比（ORs）及其95%置信区间，调整了产妇年龄、儿童出生年份、社会经济地位和产妇身体疾病负担。我们使用基于父亲暴露的阴性对照方法检查潜在的家族性混杂。结果：在74,533例患儿中，6,674例（9.1%）为出生并发症，14,569例（19.9%）为先天性异常。对潜在混杂因素进行校正后，孕期产妇心理健康诊断与新生儿逆境的这些测量结果显著相关(分娩并发症：OR =1.3 (1.2-1.4), p mat=1.3 (1.1-1.4), p pat=1.2 (1.1-1.3), p = 0.004；先天性畸形:ORmat = 1.2 (1.1 - -1.3), p pat = 1.1 (1.0 - -1.2), p = 0.01)。结论：生理健康和家族因素在产妇心理健康与新生儿逆境的关系中起作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Women's Mental Health 医学-精神病学

CiteScore

8.00

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.