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母亲的抑郁症状、感知压力与胎儿生长

Maternal Depressive Symptoms, Perceived Stress, and Fetal Growth.

作者信息

Grobman William A, Wing Deborah A, Albert Paul, Kim Sungduk, Grewal Jagteshwar, Guille Constance, Newman Roger, Chien Edward K, Owen John, D'Alton Mary E, Wapner Ronald, Sciscione Anthony, Grantz Katherine L

机构信息

Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

University of California, Irvine, and Long Beach Memorial Medical Center/Miller Children's Hospital, Irvine, California, USA.

出版信息

J Ultrasound Med. 2017 Aug;36(8):1639-1648. doi: 10.7863/ultra.16.08085. Epub 2017 Apr 10.

Abstract

OBJECTIVES

To determine whether longitudinal fetal growth is altered among pregnant women reporting greater perceived stress or more symptoms of depression.

METHODS

This analysis was based on a multicenter longitudinal study of fetal growth. Women were screened at gestational ages of 8 weeks to 13 weeks 6 days for low-risk status and underwent serial sonographic examinations. At each study visit during pregnancy, women were asked to complete the Cohen Perceived Stress Scale (PSS) and Edinburgh Postpartum Depression Survey (EPDS). Growth curves for estimated fetal weight and individual biometric parameters were created by using linear mixed models with cubic splines and compared on the basis of whether women scored 15 or higher on the PSS or 10 or higher on the EPDS either at the start of or at any time during pregnancy.

RESULTS

Of the 2334 women enrolled in the study, 2088 (89%) and 2108 (90%) completed the PSS and EPDS, respectively, at least once in all trimesters. The longitudinal growth curves of estimated fetal weight as well as all individual biometric parameters were similar (P > .05) regardless of whether the participants reported PSS of 15 or higher or EPDS of 10 or higher in the first trimester or whether these scores persisted throughout the pregnancy. Similarly, effect modification by race/ethnicity was not statistically significant for the biometric parameters under study (P > .05 for all race/ethnicity interactions).

CONCLUSIONS

More depressive symptoms and greater perceived stress, as quantified by the EPDS and the PSS, respectively, are not associated with alterations in fetal growth throughout gestation.

摘要

目的

确定在报告有更大感知压力或更多抑郁症状的孕妇中,胎儿纵向生长是否会发生改变。

方法

本分析基于一项关于胎儿生长的多中心纵向研究。在孕8周 至13周6天时对女性进行低风险状态筛查,并进行系列超声检查。在孕期的每次研究访视时,要求女性完成科恩感知压力量表(PSS)和爱丁堡产后抑郁量表(EPDS)。通过使用带有三次样条的线性混合模型创建估计胎儿体重和各个生物测量参数的生长曲线,并根据女性在孕期开始时或孕期任何时间的PSS得分是否为15分或更高,或EPDS得分是否为10分或更高进行比较。

结果

在该研究纳入的2334名女性中,2088名(89%)和2108名(90%)在所有孕期至少分别完成了一次PSS和EPDS。无论参与者在孕早期报告的PSS是否为15分或更高,或EPDS是否为10分或更高,以及这些得分在整个孕期是否持续,估计胎儿体重以及所有个体生物测量参数的纵向生长曲线都是相似的(P>0.05)。同样,种族/族裔对所研究生物测量参数的效应修正也无统计学意义(所有种族/族裔交互作用的P>0.05)。

结论

分别由EPDS和PSS量化的更多抑郁症状和更大感知压力与整个孕期胎儿生长的改变无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/526a/5967616/0955f611e1d9/nihms968114f1.jpg

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