我们能否使用爱丁堡产后抑郁量表在产后即刻识别出有产后抑郁风险的母亲？

Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh Postnatal Depression Scale?

作者信息

Dennis Cindy-Lee

机构信息

Faculty of Nursing, University of Toronto, 50 St. George Street, Toronto, Ont., Canada M5S 3H4.

出版信息

J Affect Disord. 2004 Feb;78(2):163-9. doi: 10.1016/s0165-0327(02)00299-9.

DOI:10.1016/s0165-0327(02)00299-9

PMID:14706728

Abstract

BACKGROUND

Postpartum depression is a major health issue for many women around the world with well-documented negative health consequences for the mother, child and family. While research has demonstrated the amenability of postpartum depression to treatment, there is preliminary evidence suggesting maternal mood in the immediate postpartum period may be predictive of postpartum depression such that secondary preventive interventions may be implemented.

METHODS

A population-based sample of 594 mothers completed the Edinburgh Postnatal Depression Scale (EPDS) at 1, 4 and 8 weeks postpartum. The sensitivity, specificity and predictive power of the 1-week EPDS in relation to identifying mothers with elevated EPDS scores at 4 and 8 weeks was determined. The predictive power of the 1-week EPDS was further assessed using odds ratios and receiver operator characteristic (ROC) curves.

RESULTS

At 1 week postpartum, 29.5% of mothers scored >9 on the EPDS, decreasing to 23% at 4 weeks and 20.5% at 8 weeks. Using the cut-off score of 9/10, the 1-week EPDS accurately classified 85.4% mothers at 4 weeks and 82.5% mothers at 8 weeks with or without postpartum depression symptomatology. The 1-week EPDS was significantly correlated to the 4-week (r=0.72, P<0.001) and 8-week (r=0.65, P<0.001) EPDS. Mothers with a 1-week EPDS score >9 were 30.3 times more likely at 4 weeks (95% CI=17.5-42.3) and 19.1 times more likely at 8 weeks (95% CI=11.0-32.9) to exhibit postpartum depression symptomatology.

LIMITATIONS

Psychiatric interviews were not completed in collaboration with the EPDS.

CONCLUSION

The EPDS administered in the 1st week postpartum was predictive of maternal mood at 4 and 8 weeks postpartum. To identify mothers at high risk for postpartum depression, health care professionals could consider screening all new mothers in the immediate postpartum period such that secondary preventive interventions may be implemented.

摘要

背景

产后抑郁是全球众多女性面临的一个重大健康问题，对母亲、孩子和家庭都有确凿的负面健康影响。虽然研究表明产后抑郁可通过治疗改善，但有初步证据显示产后即刻的母亲情绪可能是产后抑郁的预测指标，因此可以实施二级预防干预措施。

方法

选取594名母亲作为基于人群的样本，她们在产后1周、4周和8周完成了爱丁堡产后抑郁量表（EPDS）。确定产后1周EPDS对于识别产后4周和8周时EPDS得分升高的母亲的敏感性、特异性和预测能力。使用优势比和受试者工作特征（ROC）曲线进一步评估产后1周EPDS的预测能力。

结果

产后1周时，29.5%的母亲EPDS得分>9分，4周时降至23%，8周时降至20.5%。以9/10分为临界值，产后1周的EPDS能准确分类产后4周时85.4%的母亲以及产后8周时82.5%有或没有产后抑郁症状的母亲。产后1周的EPDS与产后4周（r = 0.72，P < 0.001）和8周（r = 0.65，P < 0.001）的EPDS显著相关。产后1周EPDS得分>9分的母亲在产后4周出现产后抑郁症状的可能性是其他母亲的30.3倍（95%可信区间=17.5 - 42.3），在产后8周出现产后抑郁症状的可能性是其他母亲的19.1倍（95%可信区间=11.0 - 32.9）。