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孕妇伴或不伴抑郁症的产科结局:基于人群的比较。

Obstetric outcomes in pregnant women with and without depression: population-based comparison.

机构信息

Department of Medical Research, Mackay Memorial Hospital, New Taipei, 251, Taiwan.

Department of Public Health, China Medical University, Taichung, 404, Taiwan.

出版信息

Sci Rep. 2017 Oct 24;7(1):13937. doi: 10.1038/s41598-017-14266-3.

Abstract

This study used insurance claims data to evaluate obstetric outcomes in pregnant women with and without depression because population study for Asian women on the issue is limited. We identified 5,064 women with depression at pregnancy in 2005-2013, and 20,024 pregnant women without depression, frequency matched by age, pregnant year and parity. Obstetric events during pregnancy and deliveries were evaluated. The depression group had more events than comparisons for hyperemesis (39.3 vs. 35.5%), abortion (3.3 vs. 2.6%), malpresentation (12.3 vs. 10.3%), C-section (40.2 vs. 34.6%) and intrauterine fetal demise (0.7 vs. 0.4%); risks of these events were significant for childbearing depressed women, not for the 35+ years subgroup. These incidences were higher in depressed women taking antidepressant than those without the medication, but were significant in childbearing depressed subgroup for hyperemesis and C-section with odds ratios of 1.18 (95% confidence intervals (CI), 1.02-1.36) and 1.29 (95% CI, 1.11-1.49), respectively. Incident preterm and low birth weight births were also higher in the depression group than in comparisons, but weren't significant. In conclusion, women with depression during pregnancy may develop more adverse events than comparisons and are more likely to have a C-section delivery.

摘要

本研究利用保险索赔数据评估了患有和未患有抑郁症的孕妇的产科结局,因为针对亚洲女性的人群研究对此问题有限。我们在 2005 年至 2013 年期间确定了 5064 名患有抑郁症的孕妇,并按年龄、怀孕年份和产次频率匹配了 20024 名未患有抑郁症的孕妇。评估了怀孕期间和分娩时的产科事件。与对照组相比,抑郁症组出现更多的事件,包括妊娠剧吐(39.3%比 35.5%)、流产(3.3%比 2.6%)、胎位不正(12.3%比 10.3%)、剖宫产(40.2%比 34.6%)和胎儿宫内死亡(0.7%比 0.4%);这些事件的风险对有生育抑郁症的女性是显著的,但对 35 岁以上的亚组则不然。与未服用抗抑郁药的抑郁症女性相比,服用抗抑郁药的抑郁症女性发生这些事件的几率更高,但在有生育抑郁症的亚组中,抗抑郁药与妊娠剧吐和剖宫产的比值比分别为 1.18(95%置信区间(CI),1.02-1.36)和 1.29(95%CI,1.11-1.49),具有统计学意义。抑郁症组早产和低出生体重儿的发生率也高于对照组,但无统计学意义。总之,怀孕期间患有抑郁症的女性可能比对照组出现更多的不良事件,并且更有可能进行剖宫产分娩。

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