Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts, 405 Arnold House, 715 North Pleasant Street, Amherst, MA 01003-9304, USA.
Matern Child Health J. 2011 Nov;15(8):1287-95. doi: 10.1007/s10995-010-0673-9.
Prior studies of risk factors for depressive symptoms during pregnancy are sparse and the majority have focused on non-Hispanic white women. Hispanics are the largest minority group in the US and have the highest birth rates. We examined associations between pre and early pregnancy factors and depressive symptoms in early pregnancy among 921 participants in Proyecto Buena Salud, an ongoing cohort of pregnant Puerto Rican and Dominican women in Western Massachusetts. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (mean=13 weeks gestation) by bilingual interviewers who also collected data on sociodemographic, acculturation, behavioral, and psychosocial factors. A total of 30% of participants were classified as having depressive symptoms (EPDS scores>12) with mean+SD scores of 9.28+5.99. Higher levels of education (college/graduate school vs. <high school: RR=0.60, 95% CI 0.41-0.86), household income (Ptrend=0.02), and living with a spouse/partner (0.80; 95% CI 0.63-1.00) were independently associated with lower risk of depressive symptoms. There was the suggestion that failure to discontinue cigarette smoking with the onset of pregnancy (RR=1.32; 95% CI 0.97-1.71) and English language preference (RR=1.33; 95% CI 0.96-1.70) were associated with higher risk. Single marital status, second generation in the U.S., and higher levels of alcohol consumption were associated with higher risk of depressive symptoms in univariate analyses, but were attenuated after adjustment for other risk factors. Findings in the largest, fastest-growing ethnic minority group can inform intervention studies targeting Hispanic women at risk of depression in pregnancy.
先前关于怀孕期间抑郁症状风险因素的研究较少，且大多数研究都集中在非西班牙裔白人女性上。西班牙裔是美国最大的少数族裔群体，且出生率最高。我们研究了在马萨诸塞州西部进行的 Proyecto Buena Salud 项目中的 921 名波多黎各和多米尼加孕妇中，妊娠前和孕早期的因素与妊娠早期抑郁症状之间的关系。通过双语访谈者使用爱丁堡产后抑郁量表（平均妊娠 13 周时）评估抑郁症状，访谈者还收集了社会人口统计学、文化适应、行为和心理社会因素的数据。共有 30%的参与者被归类为患有抑郁症状（EPDS 评分>12），平均+SD 得分为 9.28+5.99。更高的教育水平（大学/研究生院与<高中：RR=0.60，95%CI 0.41-0.86）、家庭收入（Ptrend=0.02）和与配偶/伴侣同住（0.80；95%CI 0.63-1.00）与较低的抑郁症状风险独立相关。有迹象表明，怀孕时未能停止吸烟（RR=1.32；95%CI 0.97-1.71）和偏好英语（RR=1.33；95%CI 0.96-1.70）与更高的风险相关。在单婚状态、在美国的第二代和更高的酒精摄入量在单因素分析中与抑郁症状的更高风险相关，但在调整其他风险因素后则减弱。这些发现为针对有抑郁风险的西班牙裔孕妇的干预研究提供了最大、增长最快的少数族裔群体的信息。
