The Chiles Center for Healthy Mothers and Babies, University of South Florida, Tampa, Florida, USA.
J Womens Health (Larchmt). 2009 Nov;18(11):1841-6. doi: 10.1089/jwh.2008.1261.
Data on risk factors for major antenatal depression among African American women are scant. In this study, we seek to determine the prevalence and risk factors for major antenatal depression among low-income African American women receiving prenatal services through the Central Hillsborough Healthy Start (CHHS).
Women were screened using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff of > or =13 as positive for risk of major antenatal depression. In total, 546 African American women were included in the analysis. We used logistic regression to identify risk factors for major antenatal depression.
The prevalence of depressive symptomatology consistent with major antenatal depression was 25%. Maternal age was identified as the main risk factor for major antenatal depression. The association between maternal age and risk for major antenatal depression was biphasic, with a linear trend component lasting until age 30, at which point the slope changed markedly tracing a more pronounced likelihood for major depression with advancing age. Women aged > or =30 were about 5 times as likely to suffer from symptoms of major antenatal depression as teen mothers (OR = 4.62, 95% CI 2.23-9.95).
The risk for major antenatal depression increases about 5-fold among low-income African American women from age 30 as compared to teen mothers. The results are consistent with the weathering effect resulting from years of cumulative stress burden due to socioeconomic marginalization and discrimination. Older African American mothers may benefit from routine antenatal depression screening for early diagnosis and intervention.
关于非裔美国女性发生产前重度抑郁症的风险因素的数据很少。在这项研究中，我们试图确定在接受产前服务的低收入非裔美国女性中，通过中央希尔斯伯勒健康启动（CHHS）发生产前重度抑郁症的患病率和风险因素。
采用爱丁堡产后抑郁量表（EPDS）对女性进行筛查，以>或=13 分为产前重度抑郁症的风险阳性标准。共纳入 546 名非裔美国女性进行分析。我们使用逻辑回归来确定产前重度抑郁症的风险因素。
符合产前重度抑郁症的抑郁症状患病率为 25%。母亲年龄是非裔美国女性产前重度抑郁症的主要危险因素。母亲年龄与产前重度抑郁症风险之间存在双相关联，线性趋势部分持续到 30 岁，此时斜率明显改变，随着年龄的增长，重度抑郁症的可能性明显增加。年龄>或=30 岁的女性患产前重度抑郁症的可能性是青少年母亲的 5 倍（OR=4.62，95%CI 2.23-9.95）。
与青少年母亲相比，低收入非裔美国女性从 30 岁开始，产前重度抑郁症的风险增加了近 5 倍。这些结果与由于社会经济边缘化和歧视而导致多年累积的压力负担造成的“老化”效应一致。年龄较大的非裔美国母亲可能受益于常规产前抑郁症筛查，以便早期诊断和干预。
