1 Division of Psychiatry, Niguarda Ca' Granda Hospital, Milan, Italy.
2 Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Int J Soc Psychiatry. 2017 Nov;63(7):622-631. doi: 10.1177/0020764017725543. Epub 2017 Aug 14.
Although several studies have analyzed the risk factors of antenatal and post-partum depression, evidence on the prevalence and the risk profile for antenatal depressive symptoms (ADS) between native-born and different groups of non-native born women living in the same country is scant. The aim of this article is to compare the prevalence and the risk profile for ADS across geographical areas in women recruited from two large hospitals of North-western Italy.
The presence of ADS was defined as an Edinburgh Post-natal Depression Scale (EPDS) score ≥12 or a Beck Depression Inventory, Short Form (BDI-SF) score ≥9 or the presence of suicidal ideation/behavior. Crude and adjusted odds ratios (ORs) of ADS were calculated using logistic regression models.
The prevalence of ADS was 12.4% among Italian women and ranged from 11.4% in other European to 44.7% in North-African women. Crude ORs of ADS were OR = 3.3 (95% confidence interval (CI), 1.2-8.8) for Asian, 3.3 (95% CI, 1.9-5.6) for South-American and 5.7 (95% CI, 3.4-9.6) for North-African women. Marital problems, at-risk pregnancy, past psychiatric history, pharmacological treatment, psychological treatment, financial problems, change in residence and number of children were significantly associated with ADS in multivariate analyses, regardless of women's origin. After adjusting for these variables, the OR of ADS remained significant for South-American and North-African women.
Our results demonstrate that the risk of ADS varies across geographical areas of origin and is highest among North-African women. The risk factors identified should be assessed in routine obstetric care to inform decisions about interventions to prevent post-partum depression and its consequences on the mothers and the newborns.
尽管已有多项研究分析了产前和产后抑郁的风险因素，但关于在同一国家生活的本地出生和不同非本地出生妇女的产前抑郁症状（ADS）的流行率和风险特征的证据很少。本文旨在比较意大利两家大型医院招募的妇女在不同地理区域的 ADS 流行率和风险特征。
采用爱丁堡产后抑郁量表（EPDS）评分≥12 分或贝克抑郁自评量表短式（BDI-SF）评分≥9 分或存在自杀意念/行为，来定义 ADS 的存在。使用逻辑回归模型计算 ADS 的粗比值比（OR）和调整比值比（aOR）。
意大利妇女的 ADS 患病率为 12.4%，其他欧洲地区为 11.4%，北非地区为 44.7%。亚洲、南美和北非妇女的 ADS 粗 OR 分别为 3.3（95%可信区间[CI]，1.2-8.8）、3.3（95% CI，1.9-5.6）和 5.7（95% CI，3.4-9.6）。多变量分析显示，婚姻问题、高危妊娠、既往精神病史、药物治疗、心理治疗、经济问题、居住地变化和子女数量与 ADS 显著相关，而与妇女原籍国无关。在调整这些变量后，ADS 的 OR 对于南美和北非妇女仍然显著。
我们的结果表明，ADS 的风险在原籍国的地理区域之间存在差异，北非妇女的风险最高。应在常规产科护理中评估确定的这些风险因素，以告知有关干预措施的决策，以预防产后抑郁症及其对母亲和新生儿的影响。
