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一项随机对照试验:产前抑郁干预对患有医学定义并发症的中国高危孕妇围产期结局的影响。

A randomized controlled trial: effects of a prenatal depression intervention on perinatal outcomes among Chinese high-risk pregnant women with medically defined complications.

作者信息

Zhao Ying, Munro-Kramer Michelle L, Shi Shenxun, Wang Jing, Luo Jianfeng

机构信息

School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, People's Republic of China.

Psychiatry Department, Fudan University Affiliated Huashan Hospital, No. 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China.

出版信息

Arch Womens Ment Health. 2017 Apr;20(2):333-344. doi: 10.1007/s00737-016-0712-7. Epub 2017 Jan 5.

Abstract

UNLABELLED

Prenatal psychosocial health has been linked with health behaviors, maternal health, and birth outcomes. This randomized controlled trial evaluated the effects of a prenatal depression intervention on birth outcomes and maternal physical and psychological status at 42 days postpartum. Three hundred fifty-two high-risk pregnant women exposed to obstetric complications with an Edinburgh Postnatal Depression Scale (EPDS) ≥ 9 or a Postpartum Depression Screening Scale (PDSS) ≥ 60 were randomly assigned to the intervention group (n = 176) and control group (n = 176). The intervention group underwent a six-session couple-separated psycho-educational program; the control group received the usual care. All participants were asked to complete questionnaires at late pregnancy (>28 weeks), 3 days postpartum, and 42 days postpartum. The intervention group had a significantly lower cesarean rate and shorter third stage of labor (p < .05). At 42 days after delivery, only 5.1% of participants were lost to follow-up, and the intervention group had significantly less minor and major depression, more sleep time, more satisfaction with their husband and other family members, less concern about taking care of baby, and less breast milk insufficiency than the control group (p < .05). A prenatal psychological intervention model for high-risk pregnant women holds potential as a preventive program that addresses maternal health and birth outcomes.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (ChiCTR-IOR-15006433), http://www.chictr.org.cn/enIndex.aspx (retrospectively registered).

摘要

未标注

产前心理社会健康与健康行为、孕产妇健康及分娩结局相关。这项随机对照试验评估了产前抑郁症干预对产后42天分娩结局及产妇身心状况的影响。352名有产科并发症且爱丁堡产后抑郁量表(EPDS)≥9或产后抑郁筛查量表(PDSS)≥60的高危孕妇被随机分为干预组(n = 176)和对照组(n = 176)。干预组接受了为期六节的夫妻分开的心理教育项目;对照组接受常规护理。所有参与者被要求在孕晚期(>28周)、产后3天及产后42天完成问卷调查。干预组剖宫产率显著较低,且第三产程较短(p < 0.05)。分娩后42天,仅5.1%的参与者失访,且干预组与对照组相比,轻、重度抑郁症显著更少,睡眠时间更多,对丈夫及其他家庭成员的满意度更高,对照顾婴儿的担忧更少,母乳不足情况也更少(p < 0.05)。针对高危孕妇的产前心理干预模式作为一项解决孕产妇健康及分娩结局的预防项目具有潜力。

试验注册

中国临床试验注册中心(ChiCTR-IOR-15006433),http://www.chictr.org.cn/enIndex.aspx(回顾性注册)

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