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加拿大女性慢性围产期疼痛是产后抑郁症状的一个风险因素。

Chronic perinatal pain as a risk factor for postpartum depression symptoms in Canadian women.

机构信息

1) McGill University 2) Centre de santé et services sociaux (CSSS) De La Montagne.

出版信息

Can J Public Health. 2013 Sep 18;104(5):e375-87. doi: 10.17269/cjph.104.4029.

Abstract

OBJECTIVE

To examine whether problematic perinatal pain is associated with postpartum depression (PPD) symptoms in a large nationally representative sample of Canadian mothers.

METHODS

We conducted a secondary data analysis using the 2006 Canadian Maternity Experiences Survey data (n=5,614). The main exposures of interest were the presence of problematic perinatal pain at three months postpartum, the duration of problematic perinatal pain, and the number of types of perinatal pain (vagina, caesarean incision site, breasts, back, severe headaches) at the time of interview (mean=7.3 months, range 5-14 months). For each exposure, full multivariate logistic regression models as well as six submodels were fitted.

RESULTS

Odds of screening positive for PPD symptoms for respondents reporting problematic perinatal pain in the first three months postpartum were 1.7 (95% CI 1.2-2.5). Compared to respondents without problematic perinatal pain, the odds of PPD symptoms for women reporting problematic perinatal pain at the time of interview was 2.4 (95% CI 1.6-3.6). A dose-response association between the number of types of perinatal pain at the time of interview and PPD symptoms was also observed.

CONCLUSION

Mothers reporting persistent perinatal pain are at increased risk of developing PPD, and pain control services for these women may be needed.

摘要

目的

在加拿大母亲的大型全国代表性样本中,研究围产期疼痛问题是否与产后抑郁症(PPD)症状有关。

方法

我们使用 2006 年加拿大孕产经历调查数据(n=5614)进行了二次数据分析。主要暴露因素是产后三个月存在围产期疼痛问题、围产期疼痛持续时间以及访谈时存在的围产期疼痛类型(阴道、剖宫产切口、乳房、背部、严重头痛)数量(平均 7.3 个月,范围 5-14 个月)。对于每种暴露因素,都拟合了完整的多变量逻辑回归模型和六个子模型。

结果

报告产后三个月内存在围产期疼痛问题的受访者筛查出 PPD 症状的几率为 1.7(95%CI 1.2-2.5)。与没有围产期疼痛问题的受访者相比,报告访谈时存在围产期疼痛问题的女性患 PPD 症状的几率为 2.4(95%CI 1.6-3.6)。还观察到访谈时围产期疼痛类型数量与 PPD 症状之间存在剂量反应关系。

结论

报告持续性围产期疼痛的母亲患 PPD 的风险增加,可能需要为这些女性提供疼痛控制服务。

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本文引用的文献

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Postpartum depression: current status and future directions.产后抑郁症:现状与未来方向。
Annu Rev Clin Psychol. 2013;9:379-407. doi: 10.1146/annurev-clinpsy-050212-185612. Epub 2013 Feb 1.
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Early breastfeeding experiences and postpartum depression.早期母乳喂养经历与产后抑郁。
Obstet Gynecol. 2011 Aug;118(2 Pt 1):214-221. doi: 10.1097/AOG.0b013e3182260a2d.
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Pain as a confounding factor in postnatal depression screening.疼痛作为产后抑郁筛查的混杂因素。
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The Canadian maternity experiences survey: an overview of findings.加拿大孕产妇经历调查:研究结果概述
J Obstet Gynaecol Can. 2008 Mar;30(3):217-228. doi: 10.1016/S1701-2163(16)32758-X.
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Perinatal depression: a systematic review of prevalence and incidence.围产期抑郁症:患病率和发病率的系统评价
Obstet Gynecol. 2005 Nov;106(5 Pt 1):1071-83. doi: 10.1097/01.AOG.0000183597.31630.db.

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