The dynamics of mental health measures of pre- and postpartum women undergoing assisted reproductive technology

Abstract

BACKGROUND: The number of infertile women has been increasing since 2015, with a 1015% increase in IVF cycles every year. The data on mental health of women using assisted reproductive technology are contradictory; there is little research on the dynamics of mental health outcomes from pregnancy to postpartum.
 AIM: The aim of this study was to evaluate the dynamics of mental health measures in the groups of pre- and postpartum women using assisted reproductive technology and to compare these groups with women who conceived spontaneously.
 MATERIALS AND METHODS: This study had three stages: during pregnancy, within one month after delivery, and in four to nine months after childbirth, and included 59 women who used assisted reproductive technology (34.0 4.60 years old) and 85 women with natural pregnancy (30.6 4.39 years old). All the women had singleton, planned pregnancy, with the most of them at more than 20 weeks pregnant. Drop out within research stages was approximately 2030%. We used the Achenbach System of Empirically Based Assessment, socio-demographic and obstetric data gathering, as well as a postpartum telephone interview.
 RESULTS: Women in the assisted reproductive technology group were less likely (р = 0.000) to attend or plan to attend childbirth preparation courses. In this study group, emergency (40%) and planned (26%) caesarean sections were used more often (p = 0.001); in 17% of cases, they gave birth before 37 weeks of gestation (vs. 1.9% in the group of women with natural pregnancy); and only 51% of women undergoing assisted reproductive technology used breast feeding (vs. 78% in the group of women with natural pregnancy). No significant differences in Apgar scores and the number of problems in childs health straight after the delivery were shown. In 49 months after the childs birth in the group of women using assisted reproductive technology, the number of somatic disorders was significantly higher (р = 0.046) compared to the group of women with natural pregnancy. The analysis of the dynamics of mental health measures revealed an increase of withdrawal (p = 0.010) and thought problems (p = 0.001) in the group of women using assisted reproductive technology. In the group of women with natural pregnancy, the analysis revealed a decrease in the number of mental health problems such as anxiety / depression, somatic problems, delinquent behavior, as well as DSM-associated anxiety disorder and avoidance (р 0.05).
 CONCLUSIONS: Mental health measures of women undergoing assisted reproductive technology, their dynamics after childbirth, the number of preterm births and cesarean sections, as well as feeding type altogether may be a risk factor for the mental health and development of the children. These women may require additional support.