Premenstrual syndrome as a possible presymtomatic marker for negative outcomes of pregnancy

Abstract

Objective: Hungarian Family Planning Service was launched for the prevention of structural birth defects and preterm delivery in 1984. Nowadays, our basic mission consists of 2 elements: effective contraception and quantitative (positive) family planning model decreasing negative outcomes of pregnancy. The positive family planning programme begins 3 months before planned pregnancy and continues 3 months in the post-conceptional period, including information-counselling, examinations and interventions performed by qualified nurses. Special medical consultations (i.e., gynaecologist, andrologist, psychiatrist, sexual-medicine) are also linked to the basic service, which are available if the clients' need to be addressed. Currently, we pay special attention for the psychological aspects of the peri-conceptional period as well. Childbirth as a great irreversible life event is a normative crisis of the life, thus pregnancy and postpartum period are times of high risk for psychiatric symptoms. Stress (anxiety, depression) in pre- and post-natal period has short and long-term effect on offspring. Well-tailored psychological support can be helpful in the prevention of complications. Women participating in family planning programme should be evaluated for the high risk and specific preventive programme are provided for them. To reveal high risk, we use case, family history and presymptomatic marker of depression. Method(s): Between 2010-2016, 744 women were participating in family planning service. The mean age was 32.6 +/- 0.6. They were screened for premenstrual syndrome by using the shortened form of PAF questionnaire. It was delivered from factoranalysis of Premenstrual Assessment Form considering our previous study's results. We compared healthy and PMS affected patients' data in according to the prevalence of PPD, spontaneous abortion and time needed for conception. Result(s): Prevalence of PMS in our sample was 51.4%. Overage duration between wished and realised conception was 6.1 months in healthy group vs. 9.2 months in PMS group. Postnatal depression was screened by Edinburgh Postnatal Scale and it showed about 4 times higher prevalence between affected women by PMS. Surprisingly, the rate of spontaneous abortion was 2 times higher, although the absolute number is rather low for statistical validation. Conclusion(s): Women affected by PMS can be considered as high risk for perinatal mood disorders and negative outcomes of pregnancy. PMS can be useful as a presymptomatic marker of perinatal depression and may be increased risk for spontaneous abortion. Psychological aspect should be included into the periconceptional care. Family planning may be an optimal solution to prevent perinatal depression and its complication.