Reproductive biomedicine online · 2019
First trimester depression and/or anxiety disorders increase the risk of low birthweight in IVF offspring: a prospective cohort study.
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Lang Jingwen, Zhang Bingqian, Meng Yueru, Du Yanzhi, Cui Linlin, Li Weiping
Аннотация
RESEARCH QUESTION: Are maternal depression and/or anxiety disorders (MDAD) before and during pregnancy associated with IVF outcomes?
DESIGN: A total of 5661 women starting their first IVF cycle between 15 August 2014 and 31 December 2015 were pooled from a prospective cohort of IVF-conceived children. The self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were used to determine MDAD. IVF outcomes were compared between MDAD+ and MDAD- groups.
RESULTS: A total of 10.3% (572/5556) of women had MDAD before IVF (bMDAD). The fertilization rate was lower in the bMDAD+ group (59.41 ± 22.11% versus 61.72 ± 22.18%, Padjust < 0.05). No difference was found in the other IVF outcomes. Pregnancy and neonatal outcomes in women with singleton live births were similar between the two groups. A total of 17.4% (347) women with singleton live births had MDAD during the first trimester (pMDAD). Birthweight (3383 ± 556 g versus 3447 ± 518 g, Padjust < 0.05) was lower and incidence of low birthweight (LBW) (6.9% versus 3.3%, Padjust < 0.01) was higher in the pMDAD group. After adjustment for potential confounders (gestational age, maternal age, maternal pre-pregnancy body mass index, threatened abortion, hypertensive disorder complicating pregnancy and gestational diabetes mellitus), pMDAD remained significantly associated with LBW (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.16-5.42, Padjust < 0.05). The preconception psychological state in the pMDAD group did not demonstrate any additional impact on neonatal outcomes.
CONCLUSIONS: MDAD during the first trimester is associated with increased risk of LBW in offspring, whether preconception MDAD exists or not.
DESIGN: A total of 5661 women starting their first IVF cycle between 15 August 2014 and 31 December 2015 were pooled from a prospective cohort of IVF-conceived children. The self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were used to determine MDAD. IVF outcomes were compared between MDAD+ and MDAD- groups.
RESULTS: A total of 10.3% (572/5556) of women had MDAD before IVF (bMDAD). The fertilization rate was lower in the bMDAD+ group (59.41 ± 22.11% versus 61.72 ± 22.18%, Padjust < 0.05). No difference was found in the other IVF outcomes. Pregnancy and neonatal outcomes in women with singleton live births were similar between the two groups. A total of 17.4% (347) women with singleton live births had MDAD during the first trimester (pMDAD). Birthweight (3383 ± 556 g versus 3447 ± 518 g, Padjust < 0.05) was lower and incidence of low birthweight (LBW) (6.9% versus 3.3%, Padjust < 0.01) was higher in the pMDAD group. After adjustment for potential confounders (gestational age, maternal age, maternal pre-pregnancy body mass index, threatened abortion, hypertensive disorder complicating pregnancy and gestational diabetes mellitus), pMDAD remained significantly associated with LBW (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.16-5.42, Padjust < 0.05). The preconception psychological state in the pMDAD group did not demonstrate any additional impact on neonatal outcomes.
CONCLUSIONS: MDAD during the first trimester is associated with increased risk of LBW in offspring, whether preconception MDAD exists or not.