Garcia-Esteve Lluïsa, Navarro Purificación, Ascaso Carlos, Torres Anna, Aguado Jaume, Gelabert Estel, Martín-Santos Rocío
Hospital Clínic Universitari de Barcelona, seu Maternitat, 08028, Barcelona, Spain.
Arch Womens Ment Health. 2008 Jul;11(3):193-200. doi: 10.1007/s00737-008-0012-y. Epub 2008 May 28.
The goal of this study was to identify sociodemographic, psychopathological, and obstetric risk factors associated with postnatal depression (PND) and their relative weight. A cross-sectional two-stage design was used. All consecutive women receiving a routine check-up 6 weeks postpartum at Obstetric Services during a 1-year period were included. In the first stage, women completed the Edinburgh Post-natal Depression Scale (EPDS). In the second stage, mothers with EPDS scores > or =9 and a randomized sample of 16% with EPDS <9 were explored through a structured clinical interview to diagnose DSM-IV PND (major and minor depression). Variables were entered into stepwise regression models. A total of 1,201 women were recruited and did the EPDS; 261 women with EPDS scores > or =9 and 151 with EPDS scores <9 were selected. Three hundred and thirty-four women agreed to be interviewed and 100 were diagnosed with PND. Family caregiver role (defined as women who have to take care of handicapped or ill relatives) was associated with a 4.4-fold increase in risk for major PND (OR: 4.39, 95%CI: 1.10-17.38). Premenstrual syndrome was identified as an independent risk factor for major and minor PND (OR: 1.81, 95%CI: 1.03-3.18). Moreover, previous depression, poor partner relationship, and lower social support were also confirmed as risk factors for PND. Both family caregiver role and premenstrual syndrome should be considered for inclusion in the rating scales of pregnant women at risk for PND.
本研究的目的是确定与产后抑郁症（PND）相关的社会人口学、心理病理学和产科风险因素及其相对权重。采用了横断面两阶段设计。纳入了在1年期间在产科服务部门接受产后6周常规检查的所有连续产妇。在第一阶段，产妇完成爱丁堡产后抑郁量表（EPDS）。在第二阶段，通过结构化临床访谈对EPDS评分≥9分的产妇以及16%随机抽取的EPDS评分<9分的产妇进行评估，以诊断DSM-IV PND（重度和轻度抑郁症）。将变量纳入逐步回归模型。共招募了1201名产妇并进行了EPDS测试；选择了261名EPDS评分≥9分的产妇和151名EPDS评分<9分的产妇。334名产妇同意接受访谈，其中100名被诊断为PND。家庭照顾者角色（定义为必须照顾残疾或患病亲属的女性）与重度PND风险增加4.4倍相关（比值比：4.39，95%置信区间：1.10 - 17.38）。经前综合征被确定为重度和轻度PND的独立风险因素（比值比：1.81，95%置信区间：1.03 - 3.18）。此外，既往抑郁症、伴侣关系不佳和社会支持较低也被确认为PND的风险因素。对于有PND风险的孕妇，在评定量表中应考虑纳入家庭照顾者角色和经前综合征。
