Rich-Edwards Janet W, Kleinman Ken, Abrams Allyson, Harlow Bernard L, McLaughlin Thomas J, Joffe Hadine, Gillman Matthew W
Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care, Boston, MA 02215, USA.
J Epidemiol Community Health. 2006 Mar;60(3):221-7. doi: 10.1136/jech.2005.039370.
Data are scarce regarding the sociodemographic predictors of antenatal and postpartum depression. This study investigated whether race/ethnicity, age, finances, and partnership status were associated with antenatal and postpartum depressive symptoms.
1662 participants in Project Viva, a US cohort study.
Mothers indicated mid-pregnancy and six month postpartum depressive symptoms on the Edinburgh postpartum depression scale (EPDS). Associations of sociodemographic factors with odds of scoring >12 on the EPDS were estimated.
The prevalence of depressive symptoms was 9% at mid-pregnancy and 8% postpartum. Black and Hispanic mothers had a higher prevalence of depressive symptoms compared with non-Hispanic white mothers. These associations were explained by lower income, financial hardship, and higher incidence of poor pregnancy outcome among minority women. Young maternal age was associated with greater risk of antenatal and postpartum depressive symptoms, largely attributable to the prevalence of financial hardship, unwanted pregnancy, and lack of a partner. The strongest risk factor for antenatal depressive symptoms was a history of depression (OR = 4.07; 95% CI 3.76, 4.40), and the strongest risk for postpartum depressive symptoms was depressive symptoms during pregnancy (6.78; 4.07, 11.31) or a history of depression before pregnancy (3.82; 2.31, 6.31).
Financial hardship and unwanted pregnancy are associated with antenatal and postpartum depressive symptoms. Women with a history of depression and those with poor pregnancy outcomes are especially vulnerable to depressive symptoms during the childbearing year. Once these factors are taken in account, minority mothers have the same risk of antenatal and postpartum depressive symptoms as white mothers.
关于产前和产后抑郁症的社会人口学预测因素的数据稀缺。本研究调查了种族/族裔、年龄、经济状况和伴侣关系状态是否与产前和产后抑郁症状相关。
美国队列研究“活力计划”中的1662名参与者。
母亲们在爱丁堡产后抑郁量表（EPDS）上表明妊娠中期和产后6个月的抑郁症状。估计社会人口学因素与EPDS得分>12的几率之间的关联。
抑郁症状的患病率在妊娠中期为9%，产后为8%。与非西班牙裔白人母亲相比，黑人及西班牙裔母亲抑郁症状的患病率更高。这些关联可通过少数族裔女性收入较低、经济困难以及不良妊娠结局发生率较高来解释。年轻产妇年龄与产前和产后抑郁症状的风险增加相关，这在很大程度上归因于经济困难、意外怀孕以及缺乏伴侣的普遍存在。产前抑郁症状的最强风险因素是有抑郁病史（OR = 4.07；95% CI 3.76，4.40），产后抑郁症状的最强风险因素是孕期抑郁症状（6.78；4.07，11.31）或孕前有抑郁病史（3.82；2.31，6.31）。
经济困难和意外怀孕与产前和产后抑郁症状相关。有抑郁病史的女性以及妊娠结局不良的女性在生育年份尤其易患抑郁症状。一旦考虑到这些因素，少数族裔母亲产前和产后抑郁症状的风险与白人母亲相同。
