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分娩后 48 小时的甲状腺功能作为产后抑郁症的后续标志物。

Thyroid function 48h after delivery as a marker for subsequent postpartum depression.

机构信息

University Psychiatric Hospital Institut Pere Mata, IISPV, University Rovira i Virgili, Reus, Spain.

出版信息

Psychoneuroendocrinology. 2010 Jun;35(5):738-42. doi: 10.1016/j.psyneuen.2009.10.015. Epub 2009 Nov 25.

Abstract

Physiological changes during gestation and after delivery are associated with postpartum thyroid dysfunction, which is due to thyroid autoimmunity in some cases. Postpartum thyroid dysfunction, in turn, has been associated with postpartum depression (PPD). The aim of the present study was to evaluate whether thyroid function immediately after delivery can predict postpartum depression at 8 weeks and 32 weeks after delivery. This study examined 1053 postpartum Spanish women without a previous history of depression. We evaluated depressive symptoms at 48h, 8 weeks and 32 weeks postpartum and used a diagnostic interview to confirm major depression for all probable cases. Free thyroxin (fT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibodies (TPOAb) and C-reactive protein (CRP) were assayed at 48h postpartum. Binary and multivariate logistic regression analyses were performed to determine independent risk factors for PPD. Although 152 women (14.4%) had high TPOAb (>27IU/mL) and slightly elevated TSH concentrations with normal fT4, we did not find any association between thyroid function and PPD. This thyroid dysfunction was not associated with CRP concentrations that were outside of the normal range (>3mg/L). We conclude that thyroid function at 48h after delivery does not predict PPD susceptibility.

摘要

妊娠和分娩后的生理变化与产后甲状腺功能障碍有关,在某些情况下,这种障碍是由于甲状腺自身免疫引起的。产后甲状腺功能障碍又与产后抑郁症(PPD)有关。本研究旨在评估分娩后即刻的甲状腺功能是否可以预测产后 8 周和 32 周时的产后抑郁症。本研究对 1053 名无抑郁病史的西班牙产后妇女进行了研究。我们在产后 48 小时、8 周和 32 周评估了抑郁症状,并使用诊断性访谈对所有可能的病例进行了重度抑郁症的确诊。在产后 48 小时检测游离甲状腺素(fT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)和 C 反应蛋白(CRP)。进行了二项和多变量逻辑回归分析,以确定 PPD 的独立危险因素。尽管 152 名妇女(14.4%)的 TPOAb 较高(>27IU/mL),且 TSH 浓度略有升高,而 fT4 正常,但我们未发现甲状腺功能与 PPD 之间存在任何关联。这种甲状腺功能障碍与 CRP 浓度(>3mg/L)正常范围外无关。我们的结论是,分娩后 48 小时的甲状腺功能不能预测 PPD 的易感性。

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