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新西兰成长研究项目中孕期和产后父亲抑郁症状的研究。

Paternal Depression Symptoms During Pregnancy and After Childbirth Among Participants in the Growing Up in New Zealand Study.

机构信息

Growing Up in New Zealand, University of Auckland, Auckland, New Zealand2Center for Longitudinal Research-He Ara ki Mua, School of Population Health, University of Auckland, Auckland, New Zealand.

Growing Up in New Zealand, University of Auckland, Auckland, New Zealand3School of Psychology, University of Auckland, Auckland, New Zealand.

出版信息

JAMA Psychiatry. 2017 Apr 1;74(4):360-369. doi: 10.1001/jamapsychiatry.2016.4234.

Abstract

IMPORTANCE

Antenatal and postnatal depression are known to be common and associated with poor outcomes for women and their children. There is little evidence on depression symptoms among men during the perinatal period.

OBJECTIVE

To identify characteristics associated with depression symptoms among men whose partners were pregnant and subsequently gave birth.

DESIGN, SETTING, AND PARTICIPANTS: A longitudinal cohort study provided data from a demographically diverse sample of 3523 New Zealand men who completed interviews during their partner's pregnancy and 9 months after the birth of their child. Participants were drawn from a cohort whose partners were pregnant women with a due date between April 25, 2009, and March 25, 2010, who were enrolled in the Growing Up in New Zealand study. Data analysis was conducted from September 1, 2015, to January 8, 2016.

MAIN OUTCOMES AND MEASURES

Depression symptoms were measured using the Edinburgh Postnatal Depression Scale and the 9-item Patient Health Questionnaire; elevated depression symptoms were defined as scores higher than 12 and 9, respectively.

RESULTS

The mean (SD) age of the participants at the antenatal interview was 33.20 (6.25) years (range, 16-63 years). Elevated antenatal paternal depression symptoms affected 82 fathers (2.3%) and were associated with perceived stress (odds ratio [OR], 1.38; 95% CI, 1.30-1.47) and fair to poor health during their partner's pregnancy (OR, 2.06; 95% CI, 1.18-3.61). Elevated postnatal paternal depression symptoms affected 153 (4.3%) of fathers and were associated with perceived stress in pregnancy (OR, 1.12; 95% CI, 1.08-1.17), no longer being in a relationship with the mother 9 months after childbirth (OR, 6.36; 95% CI, 2.28-17.78), having fair to poor health at 9 months (OR, 3.29; 95% CI, 2.10-5.16), being unemployed at 9 months (OR, 1.86; 95% CI, 1.11-3.10), and a history of depression (OR, 2.84; 95% CI, 1.69-4.78).

CONCLUSIONS AND RELEVANCE

Expectant fathers were at risk of depression symptoms if they felt stressed or were in poor health. Rates of elevated depression symptoms were higher during the postpartum period and were associated with adverse social and relationship factors. Identifying fathers most at risk of depressive symptoms and when best to target interventions (antenatal or postnatal) may be beneficial to men and their families.

摘要

重要性

围产期抑郁已被证实较为常见,且与母婴结局不良相关。但目前尚缺乏男性在围产期抑郁症状的相关证据。

目的

识别与配偶妊娠及产后 9 个月期间男性抑郁症状相关的特征。

设计、环境和参与者:本纵向队列研究的数据来自新西兰 3523 名男性,他们在配偶妊娠期间和孩子出生后 9 个月完成了访谈。参与者来自一个队列,其配偶是预产期在 2009 年 4 月 25 日至 2010 年 3 月 25 日之间的孕妇,这些孕妇参加了新西兰成长研究。数据分析于 2015 年 9 月 1 日至 2016 年 1 月 8 日进行。

主要结局和测量指标

采用爱丁堡产后抑郁量表和 9 项患者健康问卷评估抑郁症状;得分高于 12 分和 9 分分别定义为出现较高的抑郁症状。

结果

参与者在产前访谈时的平均(SD)年龄为 33.20(6.25)岁(范围:16-63 岁)。82 位父亲(2.3%)出现了较高的产前父亲抑郁症状,与感知压力(比值比[OR],1.38;95%置信区间[CI],1.30-1.47)和母亲妊娠期间健康状况不佳(OR,2.06;95%CI,1.18-3.61)有关。153 位父亲(4.3%)出现了较高的产后父亲抑郁症状,与妊娠期间感知压力(OR,1.12;95%CI,1.08-1.17)、孩子出生后 9 个月不再与母亲保持关系(OR,6.36;95%CI,2.28-17.78)、9 个月时健康状况不佳(OR,3.29;95%CI,2.10-5.16)、9 个月时失业(OR,1.86;95%CI,1.11-3.10)以及有抑郁史(OR,2.84;95%CI,1.69-4.78)有关。

结论和相关性

如果准父亲感到压力或健康状况不佳,他们可能会出现抑郁症状。产后出现较高抑郁症状的比例较高,且与不良的社会和关系因素有关。确定最容易出现抑郁症状的父亲以及何时针对干预(产前或产后)可能对男性及其家庭有益。

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