Faisal-Cury A, Rossi Menezes P
University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil.
Arch Womens Ment Health. 2007 Feb;10(1):25-32. doi: 10.1007/s00737-006-0164-6. Epub 2006 Dec 28.
To estimate the prevalence and risk factors for antenatal anxiety (AA) and antenatal depression (AD).
We performed a cross sectional study of 432 women attending a private clinic in the city of Osasco, São Paulo, from 5/27/1998 to 5/13/2002. The following instruments were used: Spielberger state-trait anxiety inventory (STAI), Beck depression inventory (BDI), and a questionnaire for socio-demographic and obstetric data. Inclusion criteria were: pregnant women with no past or present history of depression, psychiatric treatment, alcohol or drug abuse and no clinical and obstetric complications. The prevalence of AA, according to STAI, and AD, according to Beck Inventory, were estimated with 95% confidence intervals (95% CI). Odds ratios and 95% CI were used to examine the association between AA and AD and exposures variables.
The prevalence of AA, state and trait were 59.5 (95 CI%: 54.8:64.1%) and 45.3% (95% CI: 40.6:50.0), respectively. The prevalence of AD was 19.6 (95% CI:15.9:23.4). In the multivariate analysis, AA-trait (OR: 5.26; 95% CI 2.17:12.5, p < 0.001), AA-state (OR: 2.27; 95% CI 1.08:4.76, p = 0.02) and AD (OR: 2.43; 95% CI 1.40:4.34, p = 0.002) were associated with lower women's educational level. AA-trait (OR: 3.43; 95% CI 1.68:7.00, p = 0.001), AA-state (OR: 2.22; CI 95% 1.09:4.53, p = 0.02) and AD (OR: 2.82; CI 95% 1.35:5.97, p = 0.005) were also associated with not being married. AA-trait was associated with lower women's income (OR: 2.22; 95% CI 0.98:5.26, p = 0.05) and not being white (OR: 1.7; 95% CI 1.00:2.91, p = 0.04), while AD was associated with lower couple's income (OR: 2.43; 95% CI 1.40:4.34, p = 0.001) and greater number of previous abortions (OR: 2.21; 95% CI 1.23:3.97, p = 0.009).
Prevalence of AA and AD were high in this sample of women attending a private care setting, particularly AA state and trace. AA and AD were associated with similar socio-demographic and socio-economic risk factors, suggesting some common environmental stressors may be involved.
评估产前焦虑(AA)和产前抑郁(AD)的患病率及风险因素。
我们对1998年5月27日至2002年5月13日期间在圣保罗州奥萨斯库市一家私人诊所就诊的432名女性进行了横断面研究。使用了以下工具:斯皮尔伯格状态-特质焦虑量表(STAI)、贝克抑郁量表(BDI)以及一份关于社会人口学和产科数据的问卷。纳入标准为:既往无抑郁症病史及当前无抑郁症、无精神科治疗史、无酒精或药物滥用史且无临床和产科并发症的孕妇。根据STAI评估AA的患病率,根据贝克量表评估AD的患病率,并计算95%置信区间(95%CI)。采用比值比和95%CI来检验AA和AD与暴露变量之间的关联。
AA的状态性和特质性患病率分别为59.5(95%CI:54.8:64.1%)和45.3%(95%CI:40.6:50.0)。AD的患病率为19.6(95%CI:15.9:23.4)。在多变量分析中,特质性AA(比值比:5.26;95%CI 2.17:12.5,p<0.001)、状态性AA(比值比:2.27;95%CI 1.08:4.76,p = 0.02)和AD(比值比:2.43;95%CI 1.40:4.34,p = 0.002)与女性较低的教育水平相关。特质性AA(比值比:3.43;95%CI 1.68:7.00,p = 0.001)、状态性AA(比值比:2.22;95%CI 1.09:4.53,p = 0.02)和AD(比值比:2.82;95%CI 1.35:5.97,p = 0.005)也与未婚相关。特质性AA与女性较低收入(比值比:2.22;95%CI 0.98:5.26,p = 0.05)和非白人(比值比:1.7;95%CI 1.00:2.91,p = 0.04)相关,而AD与夫妻较低收入(比值比:2.43;95%CI 1.40:4.34,p = 0.001)和既往流产次数较多(比值比:2.21;95%CI 1.23:3.97,p = 0.009)相关。
在这家私人医疗机构就诊的女性样本中,AA和AD的患病率较高,尤其是状态性AA和特质性AA。AA和AD与相似的社会人口学和社会经济风险因素相关,提示可能涉及一些共同的环境应激源。