Dayan Jacques, Creveuil Christian, Marks Maureen N, Conroy Sue, Herlicoviez Michel, Dreyfus Michel, Tordjman Sylvie
Service de Psychiatrie de l'enfant et de l'adolescent, Centre Hospitalier Universitaire Clemenceau, 14033 Caen Cedex, France.
Psychosom Med. 2006 Nov-Dec;68(6):938-46. doi: 10.1097/01.psy.0000244025.20549.bd. Epub 2006 Nov 1.
This article investigates the effects of antenatal depression and anxiety on spontaneous preterm birth resulting either from preterm labor or preterm premature rupture of membranes.
We conducted a prospective cohort study of 681 women with singleton pregnancies consecutively recruited between 20 and 28 weeks of gestation in the Obstetrics Department of the French University Hospital of Caen. Most were of European ethnic origin and received early and regular antenatal care. The assessment of gestational age was based on ultrasound examination (occurring before 13 weeks of gestation for 94.9% of the women). Depression and anxiety were assessed using self-administered questionnaires: the Edinburgh Postnatal Depression Scale and the Spielberger State-Trait Anxiety Inventory. Logistic regression analysis, controlling for sociodemographic factors (e.g., maternal age, occupation) and obstetric factors (e.g., previous preterm birth, cervical or vaginal infection), provided adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
Spontaneous preterm birth occurred in 31 women (4.8%). The rate of spontaneous preterm birth was significantly higher among women with high depression scores (9.7%) as opposed to other women (4.0%) even after adjustment for potential confounding factors (adjusted OR = 3.3, 95% CI = 1.2-9.2, p = .020). Anxiety was not significantly associated with the outcome. There were no significant interaction effects between psychological and biomedical factors.
These findings provide evidence that antenatal depression is significantly associated with spontaneous preterm birth in a population of European women receiving early and regular care.
本文研究产前抑郁和焦虑对因早产或胎膜早破导致的自发性早产的影响。
我们对法国卡昂大学医院妇产科连续招募的681名单胎妊娠妇女进行了一项前瞻性队列研究。大多数妇女为欧洲裔，接受了早期和定期的产前护理。孕周评估基于超声检查（94.9%的妇女在妊娠13周前进行了超声检查）。使用自我填写的问卷评估抑郁和焦虑：爱丁堡产后抑郁量表和斯皮尔伯格状态-特质焦虑量表。在控制社会人口学因素（如母亲年龄、职业）和产科因素（如既往早产、宫颈或阴道感染）的情况下，进行逻辑回归分析，得出调整后的优势比（OR）和95%置信区间（CI）。
31名妇女（4.8%）发生了自发性早产。抑郁评分高的妇女自发性早产率显著更高（9.7%），而其他妇女为4.0%，即使在对潜在混杂因素进行调整后也是如此（调整后的OR = 3.3，95%CI = 1.2 - 9.2，p = 0.020）。焦虑与该结果无显著关联。心理和生物医学因素之间没有显著的交互作用。
这些发现提供了证据，表明在接受早期和定期护理的欧洲女性人群中，产前抑郁与自发性早产显著相关。
