Faisal-Cury Alexandre, Menezes Paulo Rossi, Quayle Julieta, Matijasevich Alicia
a Department of Preventive Medicine , University of São Paulo , São Paulo , Brazil.
Psychol Health Med. 2017 Jan;22(1):65-74. doi: 10.1080/13548506.2016.1153678. Epub 2016 Feb 26.
to evaluate the relationship between unplanned pregnancy (UP), a common problem in high and low income countries and maternal depression (MD).
Secondary analysis of data from a prospective cohort study with pregnant women recruited from 10 primary care clinics of the public sector in São Paulo, Brazil. Participants were questioned about pregnancy intention at 20-30 weeks of gestation. The Self Report Questionnaire score >7 was used to evaluated the presence of depression during pregnancy and 11 months after childbirth. Four groups of MD were defined: never; antenatal only; postnatal only; persistent (both antenatal/postnatal). Multinomial logistic regression was used to assess the relationship between UP and MD, controlling for confounding.
Data were analysed for 701 at the postpartum period. Five hundred and sixty-two (67.8%) women did not plan the pregnancy. Women with UP had 2.5 more risk of being depressed during both assessments (during pregnancy and postpartum) when compared to women with a planned pregnancy (RR: 2.5; 95% CI: 1.47:4.30). In the adjusted models, women with UP were significantly more likely to have persistent depression (RR: 2.3; 95% CI: 1.2:4.3).
UP is an independent risk factor for persistent depression, but not for postpartum depression.
评估意外怀孕(UP)这一在高收入和低收入国家均普遍存在的问题与产妇抑郁(MD)之间的关系。
对一项前瞻性队列研究的数据进行二次分析,研究对象为从巴西圣保罗公共部门的10家初级保健诊所招募的孕妇。在妊娠20 - 30周时询问参与者的妊娠意愿。使用自评问卷得分>7来评估孕期及产后11个月时是否存在抑郁。定义了四组产妇抑郁情况:从未抑郁;仅产前抑郁;仅产后抑郁;持续性抑郁(产前和产后均抑郁)。采用多项逻辑回归来评估意外怀孕与产妇抑郁之间的关系,并对混杂因素进行控制。
对701名产后妇女的数据进行了分析。562名(67.8%)妇女意外怀孕。与计划怀孕的妇女相比,意外怀孕的妇女在两次评估(孕期和产后)期间抑郁的风险高出2.5倍(风险比:2.5;95%置信区间:1.47 - 4.30)。在调整模型中,意外怀孕的妇女持续性抑郁的可能性显著更高(风险比:2.3;95%置信区间:1.2 - 4.3)。
意外怀孕是持续性抑郁的独立危险因素,但不是产后抑郁的独立危险因素。