Prenatal psychological distress and access to mental health care in the ELFE cohort.

Autor:	Bales M; Bordeaux University, U657, 33000 Bordeaux, France; INSERM, U657, 33000 Bordeaux, France., Pambrun E; Bordeaux University, U657, 33000 Bordeaux, France; INSERM, U657, 33000 Bordeaux, France., Melchior M; INSERM, UMRS 1136 Pierre-Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, Paris, France; Sorbonne University, UPMC Paris University, Paris, France., Glangeaud-Freudenthal NM; INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris Descartes University, Paris, France., Charles MA; Ined Inserm joint unit Elfe, Paris, France., Verdoux H; Bordeaux University, U657, 33000 Bordeaux, France; INSERM, U657, 33000 Bordeaux, France; University Department of Adult Psychiatry, Charles-Perrens Hospital, Bordeaux, France., Sutter-Dallay AL; Bordeaux University, U657, 33000 Bordeaux, France; INSERM, U657, 33000 Bordeaux, France; University Department of Adult Psychiatry, Charles-Perrens Hospital, Bordeaux, France. Electronic address: alsutter@ch-perrens.fr.
Jazyk:	angličtina
Zdroj:	European psychiatry : the journal of the Association of European Psychiatrists [Eur Psychiatry] 2015 Feb; Vol. 30 (2), pp. 322-8. Date of Electronic Publication: 2014 Dec 24.
DOI:	10.1016/j.eurpsy.2014.11.004
Abstrakt:	Background: Pregnant women are vulnerable to the deleterious impact of environmental stressors. The aims were to identify the environmental and pregnancy characteristics independently associated with prenatal psychological distress and access to mental health care. Methods: We used data from the French cohort Étude Longitudinale Française depuis l'Enfance (ELFE), a nationally representative cohort of children followed-up from birth to adulthood. Information about prenatal psychological status and access to mental health care was collected during the maternity stay. Maternal/pregnancy characteristics independently associated with psychological distress and access to mental health care were explored using multivariate analyses. Results: Of the 15,143 mothers included, 12.6% reported prenatal psychological distress. Prenatal distress was more frequent in women with very low economical status, alcohol/tobacco use, unplanned/unwanted pregnancy, late pregnancy declaration, multiparity and complicated pregnancy (high number of prenatal visits, prenatal diagnosis examination, obstetrical complications). Of the women reporting prenatal distress, 25% had a prenatal consultation with a mental health specialist and 11% used psychotropic drugs during pregnancy. Decreased likelihood to consult a mental health specialist was found in young women, with intermediate educational level and born abroad. Limitations: Causal inferences should be made cautiously as the questionnaire did not collect information on the temporal sequence between psychological distress and associated characteristics. Conclusions: Women with social and obstetrical vulnerabilities are at increased risk of poor mental health during pregnancy. Improving mental health care access during pregnancy is a public health priority. (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)
Databáze:	MEDLINE
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