{"id":106,"title":"Association of Conception Mode with Antenatal Anxiety, Depression, and Delivery Outcomes: A Multicenter Cohort Study","title_zh":"受孕方式与孕期焦虑、抑郁及分娩结局的关联：多中心队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42973587","doi":"10.2147/rmhp.s630224","pmid":"42973587","journal":"Risk Manag Healthc Policy","kind":"paper","lang":"en","published_at":"2026-10-27T00:00:00+00:00","fetched_at":"2026-11-08T03:43:53+00:00","authors":["Li Y","Liu C","Li Y","Huang L","Hu M","Yuan P","Zhang W","Xiao X","Liu F","Li X"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":2.0,"hits":["assisted reproductive","infertility"]}],"topic_score":2.0,"preference_score":0.0,"preference_labels":[],"llm_score":76.0,"final_score":76.0,"score_dims":{"novelty":66,"rigor":80,"impact":72,"relevance":92,"translation":78},"recommend_reason":"大样本多中心前瞻性队列，将受孕方式、孕期心理筛查与无医学指征剖宫产串联，为ART妊娠的产前心理干预提供量化依据；结论偏观察性关联，机制与新意有限。","keywords":["辅助生殖技术","孕期焦虑","孕期抑郁","无医学指征剖宫产","多中心队列","产前心理筛查"],"selected":1,"story_id":312,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该多中心队列纳入2023年12月至2025年12月中国三家产科中心的3458名孕妇（自然受孕1954例、不孕治疗后受孕1504例），于孕26-28周以GAD-7和EPDS评估焦虑、抑郁风险，并用多因素logistic回归分析。结果显示，不孕治疗组焦虑（21.0% vs 14.0%）与抑郁（15.2% vs 12.5%）风险均高于自然受孕；辅助生殖技术（ART）独立关联焦虑风险（aOR 1.40）及不良母儿结局（aOR 1.61），但未发现焦虑或抑郁与不良母儿结局相关。无医学指征剖宫产率为16.5%，与焦虑、抑郁、ART及药物治疗相关（aOR分别为1.88、1.55、1.43、1.53）。结论提示ART与孕期焦虑风险升高相关，心理筛查阳性与无指征剖宫产相关，支持孕期心理筛查与个体化咨询。","summary":"BACKGROUND: This study compared antenatal anxiety and depression risks across modes of conception and examined their associations with adverse maternal and neonatal outcomes and cesarean delivery without medical indication. METHODS: This multicenter cohort included 3458 pregnant women receiving antenatal care at three Chinese obstetric centers from December 2023 to December 2025, including 1954 natural conceptions and 1504 conceptions after infertility treatment. Infertility treatment was classified as assisted reproductive technology, surgery, or medical treatment. Anxiety and depression risks were assessed at 26-28 weeks using the GAD-7 and EPDS. Multivariable logistic regression was performed. RESULTS: Women conceiving after infertility treatment had higher risks of anxiety than those with natural conception (21.0% vs 14.0%, P<0.001) and depression (15.2% vs 12.5%, P=0.023). Assisted reproductive technology was independently associated with anxiety risk (aOR, 1.40; 95% CI, 1.12-1.74), whereas no infertility treatment pathway was associated with depression risk. Neither anxiety nor depression risk was associated with adverse maternal and neonatal outcomes, although assisted reproductive technology was associated with this outcome (aOR, 1.61; 95% CI, 1.32-1.96). Cesarean delivery without medical indication occurred in 16.5% of women and was associated with anxiety risk, depression risk, assisted reproductive technology, and medical treatment, with aORs of 1.88, 1.55, 1.43, and 1.53, respectively. CONCLUSION: Assisted reproductive technology was associated with increased antenatal anxiety risk. Positive anxiety and depression screens were associated with cesarean delivery without medical indication, supporting antenatal psychological screening, clinical assessment, and individualized counseling.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}