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中国人群中孕中期进行产前抑郁筛查的效用:一项三波前瞻性纵向研究。

The utility of screening for perinatal depression in the second trimester among Chinese: a three-wave prospective longitudinal study.

机构信息

School of Health Sciences, Macao Polytechnic Institute, Macau, China.

出版信息

Arch Womens Ment Health. 2010 Apr;13(2):153-64. doi: 10.1007/s00737-009-0134-x.

Abstract

This paper aims to study the pattern of perinatal depressive symptomatology and determine the predictive power of second trimester perinatal depressive symptoms for future perinatal periods. A population-based sample of 2,178 women completed the Edinburgh Postnatal Depression Scale (EPDS) in the second and third trimesters and at 6 weeks postpartum. Repeated measures ANOVAs were used to determine the EPDS scores across three stages. The predictive power of the second trimester EPDS score in identifying women with an elevated EPDS score in the third trimester and at 6 weeks postpartum were determined. The predictive power of the second trimester EPDS score was further assessed using stepwise logistic regression and receiver operator characteristic curves. EPDS scores differed significantly across three stages. The rates were 9.9%, 7.8%, and 8.7% for an EPDS score of >14 in the second and third trimesters and at 6 weeks postpartum, respectively. Using a cut-off of 14/15, the second trimester EPDS score accurately classified 89.6% of women in the third trimester and 87.2% of those at 6 weeks postpartum with or without perinatal depressive symptomatology. Women with a second trimester EPDS score >14 were 11.78 times more likely in the third trimester and 7.15 times more likely at 6 weeks postpartum to exhibit perinatal depressive symptomatology after adjustment of sociodemographic variables. The area under the curve for perinatal depressive symptomatology was 0.85 in the third trimester and 0.77 at 6 weeks postpartum. To identify women at high risk for postpartum depression, healthcare professionals could consider screening all pregnant women in the second trimester so that secondary preventive intervention may be implemented.

摘要

本研究旨在探讨围产期抑郁症状的模式,并确定孕中期围产期抑郁症状对未来围产期的预测能力。一个基于人群的 2178 名妇女样本在第二和第三孕期以及产后 6 周时完成了爱丁堡产后抑郁量表(EPDS)。重复测量方差分析用于确定三个阶段的 EPDS 评分。确定了第二孕期 EPDS 评分在识别第三孕期和产后 6 周时 EPDS 评分升高的妇女的预测能力。使用逐步逻辑回归和接收器操作特性曲线进一步评估了第二孕期 EPDS 评分的预测能力。EPDS 评分在三个阶段差异显著。第二和第三孕期及产后 6 周时 EPDS 评分>14 的发生率分别为 9.9%、7.8%和 8.7%。使用 14/15 的截断值,第二孕期 EPDS 评分准确分类了第三孕期 89.6%和产后 6 周 87.2%的有或无围产期抑郁症状的妇女。第二孕期 EPDS 评分>14 的妇女在第三孕期和产后 6 周时出现围产期抑郁症状的可能性分别是调整社会人口学变量后的 11.78 倍和 7.15 倍。第三孕期和产后 6 周时围产期抑郁症状的曲线下面积分别为 0.85 和 0.77。为了识别产后抑郁症高风险的妇女,医疗保健专业人员可以考虑在第二孕期对所有孕妇进行筛查,以便实施二级预防干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0036/2953626/ebf8eb7f54f5/737_2009_134_Fig1_HTML.jpg

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