Iliadis S I, Koulouris P, Gingnell M, Sylvén S M, Sundström-Poromaa I, Ekselius L, Papadopoulos F C, Skalkidou A
Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, 751 85, Uppsala, Sweden,
Arch Womens Ment Health. 2015 Jun;18(3):539-46. doi: 10.1007/s00737-014-0478-8. Epub 2014 Nov 6.
Postpartum depression (PPD) is a common childbirth complication, affecting 10-15 % of newly delivered mothers. This study aims to assess the association between personality factors and PPD. All pregnant women during the period September 2009 to September 2010, undergoing a routine ultrasound at Uppsala University Hospital, were invited to participate in the BASIC study, a prospective study designed to investigate maternal well-being. Depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) while the Depression Self-Rating Scale (DSRS) was used as a diagnostic tool for major depression. Personality traits were evaluated using the Swedish Universities Scale of Personality (SSP). One thousand thirty-seven non-depressed pregnant women were included in the study. Non-depressed women reporting high levels of neuroticism in late pregnancy were at high risk of developing postpartum depressive symptoms (PPDSs) at 6 weeks and 6 months after delivery, even after adjustment for confounders (adjusted odds ratio (aOR) = 3.4, 95 % confidence interval (CI) 1.8-6.5 and adjusted odds ratio (aOR) = 3.9, 95 % CI 1.9-7.9). The same was true for a DSRS-based diagnosis of major depression at 6 months postpartum. Somatic trait anxiety and psychic trait anxiety were associated with increased risk for PPDS at 6 weeks (aOR = 2.1, 95 % CI 1.2-3.5 and aOR = 1.9, 95 % CI 1.1-3.1), while high scores of mistrust were associated with a twofold increased risk for PPDS at 6 months postpartum (aOR 1.9, 95 % CI 1.1-3.4). Non-depressed pregnant women with high neuroticism scores have an almost fourfold increased risk to develop depressive symptoms postpartum, and the association remains robust even after controlling for most known confounders. Clinically, this could be of importance for health care professionals working with pregnant and newly delivered women.
产后抑郁症(PPD)是一种常见的分娩并发症,影响着10%至15%的初产妇。本研究旨在评估人格因素与产后抑郁症之间的关联。2009年9月至2010年9月期间,在乌普萨拉大学医院接受常规超声检查的所有孕妇均受邀参加BASIC研究,这是一项旨在调查产妇幸福感的前瞻性研究。使用爱丁堡产后抑郁量表(EPDS)评估抑郁症状,而抑郁自评量表(DSRS)用作重度抑郁症的诊断工具。使用瑞典大学人格量表(SSP)评估人格特质。1037名未患抑郁症的孕妇被纳入研究。在妊娠晚期报告神经质水平较高的未患抑郁症的女性,即使在对混杂因素进行调整后,在分娩后6周和6个月时出现产后抑郁症状(PPDSs)的风险也很高(调整后的优势比(aOR)=3.4,95%置信区间(CI)1.8 - 6.5;调整后的优势比(aOR)=3.9,95% CI 1.9 - 7.9)。产后6个月基于DSRS诊断的重度抑郁症情况亦是如此。躯体特质焦虑和精神特质焦虑与产后6周时PPDS风险增加相关(aOR = 2.1,95% CI 1.2 - 3.5;aOR = 1.9,95% CI 1.1 - 3.1),而不信任得分高与产后6个月时PPDS风险增加两倍相关(aOR 1.9,95% CI 1.1 - 3.4)。神经质得分高的未患抑郁症的孕妇产后出现抑郁症状的风险几乎增加四倍,即使在控制了大多数已知混杂因素后,这种关联仍然很强。临床上,这对于为孕妇和初产妇提供护理的医护人员可能具有重要意义。