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目的探讨人工流产与随后出现的精神问题风险增加是否相关。方法对丹麦市民登记系统、丹麦精神病中心及丹麦国家病人登记簿的信息做基于人群的队列研究。选取1995—2007年曾做过妊娠早期人工流产或首次分娩无精神障碍记录的女孩或妇女。与事件前9个月对照,评估人工流产或首次分娩后12个月因各种精神障碍首次就诊率(住院和门诊患者)。结果做过人工流产的女孩和妇女精神问题就诊率:流产前14.6/1 000人年[95%CI(13.7,15.6)],流产后为15.2/1 000人年[95%CI(14.4,16.1)];有过头胎分娩的女孩和妇女精神问题就诊率:首次分娩前3.9/1 000人年[95%CI(3.7,4.2)],产后6.7/1 000人年[95%CI(6.4,7.0)]。与人工流产前比较,人工流产后因精神问题就诊率无明显增加;但与分娩前比较,分娩后精神问题就诊率明显增加,差异有统计学意义(P<0.001)。结论妊娠早期人工流产前、后因精神问题就诊率相似,研究不支持妊娠早期人工流产会增加精神问题风险的假说。
Objective To investigate whether abortion is associated with an increased risk of mental problems. Methods A population-based cohort study was conducted on information from the Danish Citizen Registration System, Danish Psychiatric Center and the Danish National Patient Register. Select girls or women who had a history of first trimester abortion or first childbirth without mental disorders from 1995-2007. Comparisons were made with the first 9 months of the incident to assess the first visit (inpatient and outpatient) due to various mental disorders for induced abortion or 12 months after first delivery. Results The prevalence of psychiatric problems among girls and women who had undergone abortion was 14.6 / 1,000 person-years before the abortion (95% CI (13.7,15.6)] and 15.2 / 1,000 person-years after the abortion (95% CI (14.4,16.1 ); The prevalence of mental problems among girls and women who had had first-child births: 3.9 per 1,000 person years before first delivery [95% CI (3.7,4.2)], 6.7 per 1,000 person years postpartum [95% CI 7.0)]. Compared with pre-abortion, there was no significant increase in the rate of visiting post-abortion due to mental problems. However, the rate of visiting post-delivery mental problems was significantly higher than that before labor (P <0.001). Conclusions Early pregnancy induced abortion is similar to psychiatric problems before and after the first trimester, and the study does not support the hypothesis that early pregnancy induced abortion will increase the risk of mental problems.