Muraca Giulia M, Joseph K S
School of Population and Public Health, and the Department of Obstetrics and Gynaecology University of British Columbia, Vancouver, BC; Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC.
J Obstet Gynaecol Can. 2014 Sep;36(9):803-810. doi: 10.1016/S1701-2163(15)30482-5.
Postpartum depression is a relatively common and potentially debilitating condition but its relationship with advanced maternal age has not been adequately studied. We evaluated the relationship between age and depression in a population-based sample of Canadian women.
Data on women aged 20 to 44 years were obtained from the Canadian Community Health Survey, 2007 to 2008. Depression was defined using the Short-Form score from the Composite International Diagnostic Interview (depression defined as a score of ≥ 5). Women were stratified according to whether they had a live birth within five years preceding the interview. Logistic regression was used to compare the prevalence of depression among women of advanced maternal age versus younger women after adjusting for education, marital status, and chronic disease.
Among women who had delivered recently, 8.0% (207 of 2326) were depressed compared with 10% (597 of 5610) of women who had not recently delivered. The prevalence of depression in women who had recently delivered was significantly higher in women aged 40 to 44 years than in women aged 30 to 35 years (adjusted OR 3.72; 95% CI 2.15 to 6.41). Depression rates were not higher among older women who had not had a recent delivery (adjusted OR among women 40 to 44 years 0.75; 95% CI 0.56 to 1.01).
Women of advanced maternal age have significantly higher rates of depression than younger women. Research is required to determine if a program of targeted depression screening and prevention will help reduce the burden of illness among older mothers.
产后抑郁症是一种相对常见且可能使人衰弱的病症,但其与高龄产妇的关系尚未得到充分研究。我们在一个基于人群的加拿大女性样本中评估了年龄与抑郁症之间的关系。
2007年至2008年加拿大社区健康调查获取了20至44岁女性的数据。使用综合国际诊断访谈的简表评分来定义抑郁症(抑郁症定义为评分≥5)。根据女性在访谈前五年内是否有活产进行分层。在调整教育程度、婚姻状况和慢性病因素后,使用逻辑回归比较高龄产妇与年轻女性中抑郁症的患病率。
在近期分娩的女性中,8.0%(2326人中的207人)患有抑郁症,而近期未分娩的女性中这一比例为10%(5610人中的597人)。近期分娩的40至44岁女性的抑郁症患病率显著高于30至35岁的女性(调整后的比值比为3.72;95%置信区间为2.15至6.41)。近期未分娩的老年女性的抑郁症发病率并不更高(40至44岁女性的调整后比值比为0.75;95%置信区间为0.56至1.01)。
高龄产妇的抑郁症发病率明显高于年轻女性。需要进行研究以确定针对性的抑郁症筛查和预防计划是否有助于减轻高龄母亲的疾病负担。