Die Bedeutung neurologischer, psychiatrischer und Suchterkrankungen für den Schwangerschaftsausgang: Fall-Kontroll-Studie der Geburtsjahrgänge 2010–2012

 

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Zusammenfassung

Hintergrund und Fragestellung: Die Prävalenz für neurologische und psychiatrische Erkrankungen nimmt weltweit stetig zu. Davon sind auch Frauen im gebärfähigen Alter zunehmend betroffen. Die Studie geht der Frage nach, welche Auswirkungen diese Erkrankungen pränatal auf Mutter und Kind haben.

Methodik: In einer Fall-Kontroll-Studie wurden Unterschiede im Schwangerschaftsverlauf, peripartalen Verlauf und neonatalem Outcome in Abhängigkeit von neurologischen bzw. psychiatrischen Erkrankungen der Frauen untersucht. Hierbei wurden 325 schwangere Frauen mit 331 geborenen Kindern als Fälle identifiziert und 5 103 Schwangeren mit 5 195 geborenen Kindern gegenübergestellt.

Ergebnisse: Das Alter der Mutter bei Geburt war in der Fallgruppe signifikant niedriger als in der Kontrollgruppe. Die Zahl der vorausgegangenen Schwangerschaften und die Zahl der induzierten Aborte waren hingegen in der Fallgruppe signifikant höher. Auch der BMI vor der Schwangerschaft und die Dauer des stationären Aufenthalts nach der Geburt wiesen signifikant höhere Werte in der Fallgruppe auf. Weiterhin wurden die Kinder der Fallgruppe wurden im Mittel früher geboren und wiesen geringeres Gewicht, Länge und Kopfumfang auf. Die Apgar-Werte der Kinder neuropsychiatrisch erkranter Mütter waren signifikant niedriger gegenüber der Kontrollgruppe. Außerdem wurden Kinder neuropsychiatrisch erkrankter Mütter signifikant häufiger in eine pädiatrische Einrichtung verlegt und verweilten dort im Mittel länger.

Fazit: Die vorliegenden Ergebnisse zeigen, dass ein Zusammenhang zwischen einem Großteil der getesteten Parameter und einer neuropsychiatrischen Diagnose der Mutter besteht. Die interdisziplinäre Zusammenarbeit zwischen Gynäkologen, Pädiater nowie Neurologen und Psychiatern sollte gestärkt werden um eine bestmögliche medizinische Betreuung zu gewährleisten.

Abstract

Background and Aims: The worldwide prevalence of neurological and psychiatric illnesses is steadily increasing. Consequently women of childbearing age are concerned as well. This survey examines the question of what kind of effects these illnesses have prenatally on mother and child.

Methods: In a case-control study, differences in pregnancy, birth process, and birth outcome were associated with a neurological or psychiatric illness of the expectant mother. 325 pregnant women with 331 born children were identified as cases, which were compared to 5 103 non diseased pregnant women with 5 195 born children.

Results: The age of the mother for admission was significantly lower in the case group than in the control group. The number of previous gestations and the number of previous induced abortion were significantly higher in the case group. Also the BMI before pregnancy and the length of stationary stay showed significantly higher values in the case group. Children belonging to the case group were born significantly earlier, had a lower birth weight, height, and head circumference. Furthermore Apgar scores were significantly lower in the case group. The frequency of postpartum stationary stay in a childrenʼs clinic as well as the length of stationary stay were also significantly higher when the mother suffered from a neurological or a psychiatric illness.

Conclusion: The present results point out the correlation between most of the tested parameters and a neuropsychiatric illness of the newborn’s mother. The interdisciplinary collaboration between gynecologists and pediatricians, as well as neurologists and psychiatrists should be strengthened to guarantee the best possible medical care.

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