Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
Department of Public Health, Aarhus University, Aarhus, Denmark.
Br J Gen Pract. 2018 Feb;68(667):e97-e104. doi: 10.3399/bjgp18X694565. Epub 2018 Jan 15.
Depression is a common and potentially debilitating illness worldwide. Attendance to routine childcare appointments is a key point of interest in the effort to improve the health and care for families facing depression.
To evaluate the association between maternal depression and offspring non-attendance to the Danish childcare and vaccination programme (CCP) for children from 0-5 years of age. The CCP consists of seven separate visits and several vaccinations. To investigate if exposure to recent and previous depression may affect attendance differently.
Population-based cohort study using Danish nationwide registers.
Participants were all live-born children ( = 853 315) in Denmark in the period from 1 January 2000 until 31 August 2013, and their mothers. The outcome of interest was non-attendance of each one of the seven scheduled childcare visits and two vaccination entities in the CCP. Exposure was maternal (both previous and recent) depression. All information was obtained from Danish national registries.
The risk of not attending CCP was higher for children of mothers with depression. For children of mothers with previous depression, the relative risk (RR) was 1.01 (95% confidence interval [CI] = 0.98 to 1.03) at the 5-week childcare visit, and 1.12 (95% CI = 1.09 to 1.14) at the 5-year childcare visit. For children of mothers with recent depression, the RR was 1.07 (95% CI = 1.03 to 1.13) at the 5-week visit, and 1.15 (95% CI = 1.13 to 1.17) at the 5-year visit. Furthermore, the risk of missing at least four of the seven childcare visits was higher for children of females with maternal depression (RR = 1.16, 95% CI = 1.13 to 1.19).
Maternal depression seems to compromise CCP attendance. These findings suggest a need for careful clinical attention to these vulnerable families, even years after a diagnosis of depression.
抑郁症是一种在全球范围内普遍存在且可能使人衰弱的疾病。参加常规儿童保健预约是改善面临抑郁症的家庭健康和护理的一个重要关注点。
评估母亲抑郁与 0-5 岁儿童丹麦儿童保育和疫苗接种计划（CCP）就诊率之间的关联。CCP 由七次单独的就诊和几次疫苗接种组成。研究最近和以前的抑郁暴露是否会以不同的方式影响就诊率。
使用丹麦全国登记册进行基于人群的队列研究。
参与者均为 2000 年 1 月 1 日至 2013 年 8 月 31 日期间在丹麦出生的活产儿（=853315 名）及其母亲。感兴趣的结局是 CCP 中七次预定的儿童保育就诊和两次疫苗接种的任意一次未就诊。暴露是母亲（既往和近期）抑郁。所有信息均从丹麦国家登记册获得。
患有抑郁症母亲的孩子不参加 CCP 的风险更高。对于患有既往抑郁症母亲的孩子，第 5 周儿童保健就诊时的相对风险（RR）为 1.01（95%置信区间[CI]为 0.98 至 1.03），第 5 年儿童保健就诊时为 1.12（95%CI = 1.09 至 1.14）。对于患有近期抑郁症母亲的孩子，第 5 周就诊时 RR 为 1.07（95%CI = 1.03 至 1.13），第 5 年就诊时 RR 为 1.15（95%CI = 1.13 至 1.17）。此外，患有母亲抑郁症的女性子女错过七次儿童保健就诊中的至少四次的风险更高（RR=1.16，95%CI=1.13 至 1.19）。
母亲抑郁似乎会影响 CCP 就诊率。这些发现表明，即使在抑郁症确诊多年后，也需要对这些脆弱家庭进行仔细的临床关注。
