1. Objectifs

Intentions :
«[O]ur specific objective is to measure in multigravid women the additional independent contributions of five past pregnancy outcomes – live preterm birth, live term birth, miscarriage at <20 weeks, stillbirth at ≥20 weeks, and elective abortion – to anxiety and depression as measured in each of the three trimesters in a subsequent pregnancy.» (p. 122)

Questions/Hypothèses :
«We hypothesized that previous live term births would be significantly associated with lower depression and anxiety scores and that previous live preterm births, stillbirths, miscarriages and elective abortions would be related to greater depression and anxiety symptoms. Further, we hypothesized that the associations of miscarriage with pregnancy anxiety would be stronger for pregnancy anxiety measured at the beginning of the index pregnancy, whereas the association between prior preterm birth and stillbirth with pregnancy anxiety would be stronger at the end of the index pregnancy.» (p. 122)

2. Méthode

Échantillon/Matériau :
«The 3D Cohort Study [which was conducted as part of the research program of the Integrated Research Network in Perinatology of Quebec and Eastern Ontario] comprises 2366 women recruited during the first trimester of pregnancy at one of nine clinical centers in the province of Quebec, Canada.» (p. 122)

Instruments :
Questionnaire

Type de traitement des données :
Analyse statistique

3. Résumé

«The associations for live term births and elective abortions were observed in all three trimesters of pregnancy, while the association for miscarriage was stronger and statistically significant only for first-trimester pregnancy anxiety and that for stillbirths was significant only in the third trimester. […] Our finding that prior preterm birth was associated in crude analyses with pregnancy anxiety only in the first trimester was unexpected, as we had hypothesized that this effect would be greater as the pregnancy progressed toward the third trimester, when a subsequent preterm birth was more likely to occur. Our findings for prior miscarriages and stillbirths were in line with our hypotheses regarding when in the pregnancy these exposures would exhibit the strongest effects. The effect size for prior stillbirth was moderate (40% of a standard deviation of the pregnancy anxiety scale), while those for other previous pregnancy outcomes were comparatively small (generally less than 15% of a standard deviation).» (p. 127-128) Furthermore, «[a]s expected, we found evidence for an association between prior miscarriage at <20 weeks and pregnancy anxiety in early pregnancy, with no association at mid- or late pregnancy in adjusted analyzes. […] We [also] found an association between prior elective abortion and pregnancy anxiety that was strongest in the first trimester.» (p. 128)