Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
J Affect Disord. 2011 Dec;135(1-3):128-38. doi: 10.1016/j.jad.2011.07.004. Epub 2011 Jul 29.
Little is known about the prevalence and comorbidity of Major Depressive Episode (MDE) during pregnancy in the general population. This study presents nationally representative data on the prevalence, correlates, and psychiatric comorbidities of depression in women during pregnancy and postpartum in the United States.
Data were drawn from the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC). The NESARC is a survey of 43,093 adults aged 18 years and older residing in households in the United States of whom 14,549 were women 18 to 50 years old with known past-year pregnancy status. Diagnoses of depression and other mood, anxiety, and drug disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV version.
The overall prevalence of MDE during pregnancy was 12.4%. Among pregnant and postpartum women, depression was associated with younger age, ethnicity other than Latino, being widowed, divorced, separated or never married, traumatic events within the past 12 months and pregnancy complication. Strong associations were found between MDE during pregnancy and postpartum and nearly all 12-month psychiatric disorders. Past-year depressed pregnant and postpartum women were more likely than nondepressed pregnant women to use substances (including alcohol, illicit drugs and cigarettes). Past-year pregnant and postpartum women were significantly less likely to receive past-year treatment for depression than nonpregnant women although not after adjusting for background sociodemographic characteristics.
These results indicate that depression during pregnancy and postpartum is associated with a large range of psychiatric disorders. The high frequency of psychiatric comorbidities, the elevated use of any substances and the high rate of unmet needs should be kept in mind when considering the management of depression during pregnancy and postpartum.
在普通人群中，怀孕期间重度抑郁发作（MDE）的患病率和共病情况知之甚少。本研究提供了美国孕期和产后女性抑郁患病率、相关因素和精神共病的全国代表性数据。
数据来自 2001-2002 年全国酒精相关状况流行病学调查（NESARC）。NESARC 是一项对居住在美国家庭中的 43093 名 18 岁及以上成年人进行的调查，其中包括 14549 名 18 至 50 岁已知过去一年怀孕状况的女性。抑郁和其他情绪、焦虑和药物障碍的诊断是基于酒精使用障碍和相关障碍访谈表 - DSM-IV 版本。
怀孕期间 MDE 的总体患病率为 12.4%。在怀孕和产后妇女中，抑郁与年龄较小、非拉丁裔种族、丧偶、离婚、分居或未婚、过去 12 个月内的创伤事件以及妊娠并发症有关。在怀孕期间和产后发生的 MDE 与近 12 个月的所有精神障碍之间存在强烈关联。过去一年患有抑郁的怀孕和产后妇女比未患有抑郁的怀孕妇女更有可能使用物质（包括酒精、非法药物和香烟）。过去一年怀孕和产后妇女接受抑郁治疗的可能性明显低于未怀孕妇女，尽管在调整了背景社会人口特征后并非如此。
这些结果表明，怀孕期间和产后的抑郁与多种精神障碍有关。应牢记精神共病的高频率、任何物质的使用频率升高以及未满足的需求率高，这在考虑怀孕期间和产后的抑郁管理时应予以考虑。
