Zen Watanabe1, Hidekazu Nishigori2, Kaou Tanoue3, Kosuke Tanaka1, Noriyuki Iwama4, Michihiro Satoh5, Takahisa Murakami5, Toshie Nishigori1, Satoshi Mizuno6, Kasumi Sakurai7, Mami Ishikuro8, Taku Obara9, Nozomi Tatsuta7, Masatoshi Saito1, Masahito Tachibana1, Ikuma Fujiwara7, Takahiro Arima7, Takashi Takeda10, Shinichi Kuriyama11, Kunihiko Nakai7, Nobuo Yaegashi12, Hirohito Metoki13. 1. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan. 2. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan. 3. Department of Obstetrics and Gynecology, Japanese Red Cross Ishinomaki Hospital. 71 Nishimichishita Hebita, Ishinomaki, Miyagi 986-8522, Japan. 4. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Department of Obstetrics and Gynecology, Osaki Citizen Hospital. 3-8-1 Furukawahonami, Osaki, Miyagi 989-6183, Japan. 5. Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine. 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan. 6. Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan. 7. Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan. 8. Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan. 9. Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan. 10. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University. 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan. 11. Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Division of Disaster Public Health, International Research Institute for Disaster Science, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan. 12. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan. 13. Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine. 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi 983-8536, Japan; Tohoku Medical Megabank Organization, Tohoku University. 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan. Electronic address: hmetoki@tohoku-mpu.ac.jp.
Abstract
BACKGROUND: Dysmenorrhea influences emotional distress as well as physical suffering in young non-pregnant women. The aim of this study was to assess the potential association between preconception dysmenorrhea and the development of psychological distress during pregnancy. METHODS: This study was a part of the Japan Environment and Children's Study (JECS), a nationwide birth cohort study conducted between 2011 and 2014 in Japan. A total of 87,102 pregnant Japanese women with no psychological distress (Kessler 6-item psychological distress scale [K6] score ≤ 12) in early pregnancy were eligible. Among these, 7626 had mild and 1638 had severe preconception dysmenorrhea. The prevalence and risk of maternal psychological distress (K6 scores ≥ 13) in the second or third trimester were compared among preconception dysmenorrhea severity groups. RESULTS: A higher percentage of women with mild (2.6%) or severe preconception dysmenorrhea (3.6%) suffered psychological distress during pregnancy compared to that in women without dysmenorrhea (2.1%). A multilevel logistic regression model, adjusting for baseline characteristics and the K6 score at enrollment, showed that the severity of dysmenorrhea was associated with psychological distress (mild dysmenorrhea: adjusted odds ratio [aOR], 1.154; 95% confidence interval [95% CI], 0.980-1.359; and severe dysmenorrhea: aOR, 1.457; 95% CI, 1.087-1.951). LIMITATIONS: Information about dysmenorrhea was obtained during early pregnancy. The JECS did not have clear diagnostic criteria for dysmenorrhea. CONCLUSIONS: Preconception dysmenorrhea is associated with an elevated incidence of psychological distress during pregnancy. Additionally, expectant mothers with a history of severe dysmenorrhea symptoms before pregnancy have a higher risk of developing psychological distress.
BACKGROUND:Dysmenorrhea influences emotional distress as well as physical suffering in young non-pregnant women. The aim of this study was to assess the potential association between preconception dysmenorrhea and the development of psychological distress during pregnancy. METHODS: This study was a part of the Japan Environment and Children's Study (JECS), a nationwide birth cohort study conducted between 2011 and 2014 in Japan. A total of 87,102 pregnant Japanese women with no psychological distress (Kessler 6-item psychological distress scale [K6] score ≤ 12) in early pregnancy were eligible. Among these, 7626 had mild and 1638 had severe preconception dysmenorrhea. The prevalence and risk of maternal psychological distress (K6 scores ≥ 13) in the second or third trimester were compared among preconception dysmenorrhea severity groups. RESULTS: A higher percentage of women with mild (2.6%) or severe preconception dysmenorrhea (3.6%) suffered psychological distress during pregnancy compared to that in women without dysmenorrhea (2.1%). A multilevel logistic regression model, adjusting for baseline characteristics and the K6 score at enrollment, showed that the severity of dysmenorrhea was associated with psychological distress (mild dysmenorrhea: adjusted odds ratio [aOR], 1.154; 95% confidence interval [95% CI], 0.980-1.359; and severe dysmenorrhea: aOR, 1.457; 95% CI, 1.087-1.951). LIMITATIONS: Information about dysmenorrhea was obtained during early pregnancy. The JECS did not have clear diagnostic criteria for dysmenorrhea. CONCLUSIONS: Preconception dysmenorrhea is associated with an elevated incidence of psychological distress during pregnancy. Additionally, expectant mothers with a history of severe dysmenorrhea symptoms before pregnancy have a higher risk of developing psychological distress.