Lara María Asunción, Navarrete Laura, Nieto Lourdes
Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México-Xochimilco 101, San Lorenzo Huipulco, 14370, Tlalpan, D.F., México.
Arch Womens Ment Health. 2016 Oct;19(5):825-34. doi: 10.1007/s00737-016-0623-7. Epub 2016 Mar 11.
Prospective studies on the predictors of postpartum depression (PPD) in Latin America are scarce, which is a matter of importance, since the significance of PPD risk factors may vary according to the level of development of a country, the types of measurement and the time periods assessed. This study identifies the prenatal predictors for PPD (diagnostic interview) and postpartum depressive symptoms (PPDS) (self-report scale) in Mexican mothers at 6 weeks and 6 months postpartum. Two hundred and ten women were interviewed using the Structured Clinical Interview (SCID-I), Patient Health Questionnaire (PHQ-9) and various risk factor scales. Univariate logistic regressions showed that social support, marital satisfaction, life events, a history of psychopathology, anxiety symptoms, depressive symptoms, the traditional female role, previous miscarriages/termination of pregnancy and unplanned/unwanted pregnancy were significant predictors for both PPD and PPDS at both assessment times in the postpartum. Education, age, marital status, income, occupation, parity, C-section and resilience were significant for only one of the measurements and/or at just one assessment time. General findings replicate a high- and low-income country observed psychosocial risk profile and confirm a sociodemographic and obstetric profile of vulnerability that is more prevalent in resource-constrained countries. PPD constitutes a high burden for new mothers, particularly for those living in low-middle-income countries who face social disadvantages (such as low educational attainment and income).
拉丁美洲关于产后抑郁症(PPD)预测因素的前瞻性研究很少,这是一个重要问题,因为PPD风险因素的重要性可能因国家发展水平、测量类型和评估时间段而异。本研究确定了墨西哥母亲产后6周和6个月时PPD(诊断访谈)和产后抑郁症状(PPDS)(自我报告量表)的产前预测因素。使用结构化临床访谈(SCID-I)、患者健康问卷(PHQ-9)和各种风险因素量表对210名女性进行了访谈。单因素逻辑回归显示,社会支持、婚姻满意度、生活事件、精神病理学病史、焦虑症状、抑郁症状、传统女性角色、既往流产/终止妊娠以及意外/非意愿妊娠在产后两个评估时间点都是PPD和PPDS的重要预测因素。教育程度、年龄、婚姻状况、收入、职业、产次、剖宫产和心理韧性仅在其中一项测量和/或仅在一个评估时间点具有显著性。总体研究结果重现了在高收入和低收入国家观察到的心理社会风险概况,并证实了社会人口学和产科脆弱性概况在资源有限的国家更为普遍。PPD给新妈妈带来了沉重负担,尤其是那些生活在中低收入国家、面临社会劣势(如低教育程度和低收入)的新妈妈。