Preconception dysmenorrhea as a risk factor for psychological distress in pregnancy: The Japan Environment and Children's Study

Japan Environment & Children's Study Group

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5 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)475-483
Number of pages9
JournalJournal of Affective Disorders
Publication statusPublished - 2019 Feb 15


  • Cohort study
  • Dysmenorrhea
  • Maternal mental health
  • Psychological distress

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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