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在首胎研究中,既往流产对后续孕期及产后抑郁症状的影响。

Effect of previous miscarriage on depressive symptoms during subsequent pregnancy and postpartum in the first baby study.

作者信息

Bicking Kinsey Cara, Baptiste-Roberts Kesha, Zhu Junjia, Kjerulff Kristen H

机构信息

College of Nursing, The Pennsylvania State University, University Park, PA, USA,

出版信息

Matern Child Health J. 2015 Feb;19(2):391-400. doi: 10.1007/s10995-014-1521-0.

Abstract

Our objective was to test the hypothesis that nulliparous women with a history of miscarriage have an increased risk of depression during late pregnancy, and at 1, 6, and 12 months postpartum compared to women without a history of miscarriage. We conducted secondary analysis of a longitudinal cohort study, the First Baby Study, and compared 448 pregnant women with a history of miscarriage to 2,343 pregnant women without a history of miscarriage on risk of probable depression (score >12 on the Edinburgh Postnatal Depression Scale). Logistic regression models were used to estimate odds ratios at each time point and generalized estimating equations were used to obtain estimates in longitudinal analysis. Women with a history of miscarriage were not more likely than woman without a history of miscarriage to score in the probable depression range during the third trimester or at 6 or 12 months postpartum but were more likely at 1 month postpartum, after adjustment for sociodemographic factors (OR 1.66, 95% CI 1.03-2.69). Women with a history of miscarriage may be more vulnerable to depression during the first month postpartum than women without prior miscarriage, but this effect does not appear to persist beyond this time period. We support the promotion of awareness surrounding this issue and recommend that research is planned to identify risk factors that may position a woman with a history of miscarriage to be at higher risk for depression.

摘要

我们的目标是检验这样一个假设

与无流产史的女性相比,有流产史的未生育女性在妊娠晚期、产后1个月、6个月和12个月时患抑郁症的风险更高。我们对一项纵向队列研究——“首个宝宝研究”进行了二次分析,比较了448名有流产史的孕妇和2343名无流产史的孕妇发生可能抑郁症(爱丁堡产后抑郁量表得分>12)的风险。使用逻辑回归模型估计每个时间点的比值比,并使用广义估计方程在纵向分析中获得估计值。在对社会人口学因素进行调整后,有流产史的女性在孕晚期、产后6个月或12个月时在可能抑郁症范围内得分的可能性并不比无流产史的女性更高,但在产后1个月时更有可能(比值比1.66,95%置信区间1.03 - 2.69)。有流产史的女性在产后第一个月可能比无流产史的女性更容易患抑郁症,但这种影响似乎不会在此时间段之后持续存在。我们支持提高对这个问题的认识,并建议计划开展研究以确定可能使有流产史的女性患抑郁症风险更高的危险因素。

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