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产后抑郁症预测因素:对 264 名孕妇和产后妇女进行前瞻性研究。

Predictors of postpartum depression: prospective study of 264 women followed during pregnancy and postpartum.

机构信息

Assistance Publique-Hôpitaux de Paris, Hôpital Louis Mourier, Psychiatry Department, Colombes, France; Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine, Paris, France; Service Hospitalo-Universitaire, Centre Hospitalier Sainte Anne, Paris, France.

Assistance Publique-Hôpitaux de Paris, Hôpital Louis Mourier, Psychiatry Department, Colombes, France; Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, Paris, France; INSERM U894, Centre Psychiatrie et Neurosciences, Paris, France.

出版信息

Psychiatry Res. 2014 Feb 28;215(2):341-6. doi: 10.1016/j.psychres.2013.10.003. Epub 2013 Nov 6.

Abstract

The prevalence of postpartum depression is approximately 13%. Postpartum depression is associated with a higher maternal morbidity and mortality, and also with pervasive effects on the emotional, cognitive and behavioral development of the child. The aim of our study was to identify socio-demographic, psychosocial and obstetrical risk factors of postpartum depression in a middle class community sample, using a prospective design. We enrolled consecutively 312 pregnant outpatients in a single maternity unit. The first assessment was conducted between 32 and 41 weeks gestation, and a second time between 6 and 8 weeks after delivery. Depressive symptoms were measured using the French version of the Edinburgh Postnatal Depression Scale (EPDS). A cut-off score of 12/30 or above was considered as indicative of Major Depression. Of the initial sample of 312 women, 264 (84.6%) were followed-up between 6 and 8 weeks after delivery and considered for analysis. Depression during pregnancy, migrant status, and physical abuse by the partner were independently associated with postpartum depression when considered together, whereas physical complications were significantly associated with postpartum depression only when adjusting for antenatal depression. Depression during pregnancy, history of physical abuse, migrant status and postpartum physical complications are four major risk factors for postpartum depression.

摘要

产后抑郁症的患病率约为 13%。产后抑郁症与产妇发病率和死亡率升高有关,也会对儿童的情绪、认知和行为发展产生广泛影响。我们的研究目的是使用前瞻性设计,在一个中产阶级社区样本中确定产后抑郁症的社会人口统计学、心理社会和产科风险因素。我们连续招募了 312 名单胎妊娠的门诊患者。第一次评估在妊娠 32 至 41 周之间进行,第二次在产后 6 至 8 周之间进行。使用法国版爱丁堡产后抑郁量表(EPDS)评估抑郁症状。将 12/30 或以上的得分视为有重度抑郁症。在最初的 312 名女性中,有 264 名(84.6%)在产后 6 至 8 周内进行了随访,并被纳入分析。当综合考虑时,孕期抑郁、移民身份和伴侣的身体虐待与产后抑郁独立相关,而仅在调整产前抑郁时,身体并发症才与产后抑郁显著相关。孕期抑郁、身体虐待史、移民身份和产后身体并发症是产后抑郁症的四个主要危险因素。

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