PDF(Pubmed)
Abstract：
BACKGROUND: Although the association between mental disorder and metabolic syndrome as a bidirectional relationship has been demonstrated, there is little knowledge of the cumulative and individual effect of these conditions on peripartum mental health. This study aims to investigate the association between metabolic syndrome conditions (MetS-C) and maternal mental illness in the perinatal period, while exploring time to incident mental disorder diagnosis in postpartum women.
METHODS: This observational study identified perinatal women continuously enrolled 1 year prior to and 1 year post-delivery using Optum\'s de-identified Clinformatics® Data Mart Database (CDM) from 2014 to 2019 with MetS-C i.e. obesity, diabetes, high blood pressure, high triglycerides, or low HDL (1-year prior to delivery); perinatal comorbidities (9-months prior to and 4-month postpartum); and mental disorder (1-year prior to and 1-year post-delivery). Additionally, demographics and the number of days until mental disorder diagnosis were evaluated in this cohort. The analysis included descriptive statistics and multivariable logistic regression. MetS-C, perinatal comorbidities, and mental disorder were assessed using the International Classification of Diseases, Ninth, and Tenth Revision diagnosis codes.
RESULTS: 372,895 deliveries met inclusion/exclusion criteria. The prevalence of MetS-C was 13.43%. Multivariable logistic regression revealed prenatal prevalence (1.64, CI = 1.59-1.70) and postpartum incident (1.30, CI = 1.25-1.34) diagnosis of mental health disorder were significantly higher in those with at least one MetS-C. Further, the adjusted odds of having postpartum incident mental illness were 1.51 times higher (CI = 1.39-1.66) in those with 2 MetS-C and 2.12 times higher (CI = 1.21-4.01) in those with 3 or more MetS-C. Young women (under the age of 18 years) were more likely to have an incident mental health diagnosis as opposed to other age groups. Lastly, time from hospital discharge to incident mental disorder diagnosis revealed an average of 157 days (SD = 103 days).
CONCLUSIONS: The risk of mental disorder (both prenatal and incident) has a significant association with MetS-C. An incremental relationship between incident mental illness diagnosis and the number of MetS-C, a significant association with younger mothers along with a relatively long period of diagnosis mental illness highlights the need for more screening and treatment during pregnancy and postpartum.
METHODS: This observational study identified perinatal women continuously enrolled 1 year prior to and 1 year post-delivery using Optum\'s de-identified Clinformatics® Data Mart Database (CDM) from 2014 to 2019 with MetS-C i.e. obesity, diabetes, high blood pressure, high triglycerides, or low HDL (1-year prior to delivery); perinatal comorbidities (9-months prior to and 4-month postpartum); and mental disorder (1-year prior to and 1-year post-delivery). Additionally, demographics and the number of days until mental disorder diagnosis were evaluated in this cohort. The analysis included descriptive statistics and multivariable logistic regression. MetS-C, perinatal comorbidities, and mental disorder were assessed using the International Classification of Diseases, Ninth, and Tenth Revision diagnosis codes.
RESULTS: 372,895 deliveries met inclusion/exclusion criteria. The prevalence of MetS-C was 13.43%. Multivariable logistic regression revealed prenatal prevalence (1.64, CI = 1.59-1.70) and postpartum incident (1.30, CI = 1.25-1.34) diagnosis of mental health disorder were significantly higher in those with at least one MetS-C. Further, the adjusted odds of having postpartum incident mental illness were 1.51 times higher (CI = 1.39-1.66) in those with 2 MetS-C and 2.12 times higher (CI = 1.21-4.01) in those with 3 or more MetS-C. Young women (under the age of 18 years) were more likely to have an incident mental health diagnosis as opposed to other age groups. Lastly, time from hospital discharge to incident mental disorder diagnosis revealed an average of 157 days (SD = 103 days).
CONCLUSIONS: The risk of mental disorder (both prenatal and incident) has a significant association with MetS-C. An incremental relationship between incident mental illness diagnosis and the number of MetS-C, a significant association with younger mothers along with a relatively long period of diagnosis mental illness highlights the need for more screening and treatment during pregnancy and postpartum.
摘要：
背景：尽管已证明精神障碍和代谢综合征之间存在双向关系，对这些疾病对围产期心理健康的累积和个体影响知之甚少。本研究旨在探讨围产期代谢综合征（MetS-C）与产妇精神疾病之间的关系。同时探讨产后妇女发生精神障碍的时间诊断。
方法：这项观察性研究使用Optum的去识别Clinformatics®DataMartDatabase（CDM）从2014年到2019年使用MetS-C，即肥胖，在分娩前1年和分娩后1年连续招募围产期妇女。糖尿病,高血压,高甘油三酯，或低HDL（分娩前1年）；围产期合并症（产后9个月和产后4个月）；和精神障碍（分娩前1年和产后1年）。此外,在该队列中评估了人口统计学和直至精神障碍诊断的天数.分析包括描述性统计和多变量逻辑回归。MetS-C,围产期合并症,和精神障碍使用国际疾病分类进行评估，第九，和第十次修订诊断代码。
结果：372,895例分娩符合纳入/排除标准。MetS-C的患病率为13.43%。多变量逻辑回归显示，在至少有一个MetS-C的人群中，产前患病率（1.64，CI=1.59-1.70）和产后事件（1.30，CI=1.25-1.34）明显更高。Further,在2个MetS-C的人群中，产后发生精神疾病的校正几率高1.51倍（CI=1.39-1.66），在3个或更多MetS-C的人群中，则高2.12倍（CI=1.21-4.01）。与其他年龄组相比，年轻女性（18岁以下）更有可能发生意外心理健康诊断。最后,从出院到精神疾病诊断的时间平均为157天(SD=103天).
结论：精神障碍（产前和事件）的风险与MetS-C有显著关联。事件性精神疾病诊断与MetS-C数量之间的增量关系，与年轻母亲的显著关联以及相对较长的精神疾病诊断期突出表明,需要在怀孕期间和产后进行更多的筛查和治疗.
方法：这项观察性研究使用Optum的去识别Clinformatics®DataMartDatabase（CDM）从2014年到2019年使用MetS-C，即肥胖，在分娩前1年和分娩后1年连续招募围产期妇女。糖尿病,高血压,高甘油三酯，或低HDL（分娩前1年）；围产期合并症（产后9个月和产后4个月）；和精神障碍（分娩前1年和产后1年）。此外,在该队列中评估了人口统计学和直至精神障碍诊断的天数.分析包括描述性统计和多变量逻辑回归。MetS-C,围产期合并症,和精神障碍使用国际疾病分类进行评估，第九，和第十次修订诊断代码。
结果：372,895例分娩符合纳入/排除标准。MetS-C的患病率为13.43%。多变量逻辑回归显示，在至少有一个MetS-C的人群中，产前患病率（1.64，CI=1.59-1.70）和产后事件（1.30，CI=1.25-1.34）明显更高。Further,在2个MetS-C的人群中，产后发生精神疾病的校正几率高1.51倍（CI=1.39-1.66），在3个或更多MetS-C的人群中，则高2.12倍（CI=1.21-4.01）。与其他年龄组相比，年轻女性（18岁以下）更有可能发生意外心理健康诊断。最后,从出院到精神疾病诊断的时间平均为157天(SD=103天).
结论：精神障碍（产前和事件）的风险与MetS-C有显著关联。事件性精神疾病诊断与MetS-C数量之间的增量关系，与年轻母亲的显著关联以及相对较长的精神疾病诊断期突出表明,需要在怀孕期间和产后进行更多的筛查和治疗.
