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美国和墨西哥拉丁裔女性的产前抑郁症。

Prenatal depression in Latinas in the U.S. and Mexico.

作者信息

Lara Ma Asunción, Le Huynh-Nhu, Letechipia Gabriela, Hochhausen Laila

机构信息

Instituto Nacional de Psiquiatría Ramón de la Fuente, Calzada México-Xochimilco 101. San Lorenzo Huipulco, Tlalpan, Mexico, DF 14370, Mexico.

出版信息

Matern Child Health J. 2009 Jul;13(4):567-76. doi: 10.1007/s10995-008-0379-4. Epub 2008 Jun 26.

Abstract

OBJECTIVES

The study aimed to investigate the prevalence of depressive symptoms and their associated risk factors during pregnancy in Latinas in the United States (U.S.) and Mexico.

METHOD

The sample included 108 women in the U.S. whose data were obtained from medical chart reviews in a community clinic in Washington, D.C., and 117 women in Mexico who participated in face-to-face interviews in the waiting rooms of primary care community centers in Mexico City. Variables, chosen to match in both countries for comparisons, were: socio-demographics, pregnancy gestation and order, social support, depressive symptoms, personal history of depression, family psychiatric history, and suicidal thoughts. Depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale (CES-D).

RESULTS

The prevalence of depressive symptoms was 32.4% for pregnant Latinas and 36.8% for Mexicans (CES-D > or = 16), and 15.7% and 23.9% (CES-D > or = 24), respectively, with no differences between groups. Separate multiple logistic regression analyses showed that for U.S. Latinas: (1) being more educated predicted depressive symptoms (CES-D > or = 16), and (2) second trimester, as compared to first, also predicted symptoms (CES-D > or /= 24). (3) History of suicidal thoughts predicted symptoms in Latinas in the U.S. (CES-D > or = 24) and in Mexico (using both definitions of high symptoms), and (4) living with a partner but not formally married and multi-parous condition predicted symptoms (CES-D > or /= 24) among pregnant Mexicans.

CONCLUSIONS

A high prevalence of depressive symptoms and significant risk factors during pregnancy were found in Latinas in U.S. and Mexico, suggesting increased risk for postpartum major depression. Implications for screening and interventions are discussed.

摘要

目的

本研究旨在调查美国和墨西哥的拉丁裔女性在孕期抑郁症状的患病率及其相关危险因素。

方法

样本包括108名美国女性,其数据来自华盛顿特区一家社区诊所的病历审查;以及117名墨西哥女性,她们在墨西哥城初级保健社区中心的候诊室接受了面对面访谈。为便于两国进行比较而选择的变量包括:社会人口统计学特征、妊娠孕周和胎次、社会支持、抑郁症状、个人抑郁病史、家族精神病史以及自杀念头。抑郁症状采用流行病学研究中心抑郁量表(CES-D)进行测量。

结果

孕期拉丁裔女性抑郁症状的患病率为32.4%,墨西哥女性为36.8%(CES-D≥16),分别有15.7%和23.9%(CES-D≥24),两组之间无差异。单独的多元逻辑回归分析显示,对于美国拉丁裔女性:(1)受教育程度较高预示着抑郁症状(CES-D≥16);(2)与孕早期相比,孕中期也预示着症状(CES-D≥24)。(3)自杀念头史预示着美国拉丁裔女性(CES-D≥24)和墨西哥女性(使用两种高症状定义)的症状;(4)与伴侣同居但未正式结婚以及多胎状况预示着墨西哥孕妇的症状(CES-D≥24)。

结论

在美国和墨西哥的拉丁裔女性中发现孕期抑郁症状的患病率较高且存在显著危险因素,提示产后重度抑郁的风险增加。文中讨论了筛查和干预的意义。

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