Valdés M, Hanchey A, Muñoz M P, Baumert B, Iglesias V
Becaria CONICYT, Programa Doctorado en Salud Pública, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Independencia 939, Santiago, Chile.
Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 150, East Green Street, 30602 Athens, GA, USA.
Rev Epidemiol Sante Publique. 2017 Nov;65(6):427-435. doi: 10.1016/j.respe.2017.05.010. Epub 2017 Oct 27.
While the relationship between inorganic arsenic exposure and psychological impairment has been studied previously, the association between low-level arsenic exposure during pregnancy and postpartum depression has not yet been examined. The objective is to estimate the association between low-level arsenic exposure during pregnancy and the Edinburgh score.
A sample of 223 women was collected from five public health services in Arica, Chile. Participation was voluntary and written consent was mandatory. Sociodemographic data related to arsenic exposure and urine samples for total inorganic arsenic assessments were collected during the second trimester. Postpartum depression symptoms were estimated by the Edinburgh Postpartum Depression scale. We examined descriptive statistics and ran multiple linear regressions. The modifying effect of age and depression history was evaluated separately.
The median for total urinary inorganic arsenic was 14.6μg/L (range: 2-69.2μg/L), the median for postpartum depression score was 8 points (range: 0-27 points) and 20.6% of women were considered as postpartum depressed. For women older than 25years old without depression history, the adjusted coefficient for the total urinary natural logarithm of inorganic arsenic in multiple linear regressions was -2.51 (95% CI: -4.54, -0.48; P-value=0.02). For women older than 25years old with a depression history, this value was 2.09 (95% CI: -0.90, 5.08; P-value=0.16).
In this cohort, the number of children, physical perception, depression history, stressful maternity, and age were associated with postpartum depression score. The Edinburgh score was associated with inorganic arsenic in women older than 25years without depression history.
虽然此前已对无机砷暴露与心理损伤之间的关系进行过研究，但孕期低水平砷暴露与产后抑郁之间的关联尚未得到检验。目的是评估孕期低水平砷暴露与爱丁堡产后抑郁量表得分之间的关联。
从智利阿里卡的五个公共卫生服务机构收集了223名女性的样本。参与是自愿的，必须提供书面同意书。在孕中期收集与砷暴露相关的社会人口统计学数据以及用于总无机砷评估的尿液样本。通过爱丁堡产后抑郁量表评估产后抑郁症状。我们检查了描述性统计数据并进行了多元线性回归分析。分别评估了年龄和抑郁病史的调节作用。
尿中总无机砷的中位数为14.6μg/L（范围：2 - 69.2μg/L），产后抑郁得分的中位数为8分（范围：0 - 27分），20.6%的女性被认为患有产后抑郁症。对于年龄大于25岁且无抑郁病史的女性，多元线性回归中尿无机砷总自然对数的调整系数为 -2.51（95%置信区间：-4.54，-0.48；P值 = 0.02）。对于年龄大于25岁且有抑郁病史的女性，该值为2.09（95%置信区间：-0.90，5.08；P值 = 0.16）。
在这个队列中，孩子数量、身体感知、抑郁病史、紧张的孕产情况和年龄与产后抑郁得分相关。爱丁堡产后抑郁量表得分与年龄大于25岁且无抑郁病史的女性体内的无机砷有关。
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