Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
J Affect Disord. 2018 Apr 1;230:71-76. doi: 10.1016/j.jad.2018.01.005. Epub 2018 Jan 31.
Our objectives were to identify subtypes of Chinese-Canadian women with unique trajectories of anxiety symptomatology over the first postpartum year, investigate covariates associated with group membership, and determine if mental healthcare utilization varies by group membership.
This was a longitudinal cohort study of 570 Chinese immigrant and Canadian-born women in Toronto, Canada with live births in 2010-2014. Covariates were age, immigrant status, income, fatigue, social support, acculturative stress, and depression. Mental healthcare utilization included visits at 4-24 weeks postpartum. Anxiety symptomatology was measured using the State-Trait Anxiety Inventory-State. Growth mixture modeling was used to identify latent classes corresponding to trajectories of anxiety symptomology at 4-52 weeks.
Three groups were identified: "consistently non-anxious" (74%, stable low levels of anxiety), "consistently anxious" (19.5%, clinically meaningful anxiety at baseline and across time), and "anxious-improving" (6.5%, high anxiety at baseline followed by decline). Compared to consistently non-anxious women, consistently anxious women were more likely to report baseline fatigue, depression, and acculturative stress; anxious-improving women were more likely to report baseline fatigue, depression, and history of depression before pregnancy. At 12-24 weeks, 13.8% of anxious-improving women sought mental healthcare compared to 8.6% of consistently-anxious women and 4.7% of non-anxious women (p = .06).
Our sample comprised Chinese immigrant and Canadian-born women; results should be replicated in other groups.
We identified three subtypes of postpartum anxiety trajectories. These groups of women may respond differently to interventions due to exposure to various combinations of risk factors.
本研究旨在识别具有独特产后第一年焦虑症状轨迹的加拿大华裔女性亚组，探讨与分组相关的协变量，并确定精神保健服务的利用是否因分组而异。
这是一项在加拿大多伦多进行的 570 名中国移民和加拿大出生的产后妇女的纵向队列研究，其分娩时间为 2010-2014 年。协变量包括年龄、移民身份、收入、疲劳、社会支持、文化适应压力和抑郁。精神保健服务的利用包括产后 4-24 周的就诊情况。焦虑症状采用状态特质焦虑量表进行测量。使用增长混合模型识别与产后 4-52 周焦虑症状轨迹相对应的潜在类别。
共识别出 3 个亚组：“始终非焦虑”（74%，稳定的低水平焦虑）、“始终焦虑”（19.5%，基线和整个时间内具有临床意义的焦虑）和“焦虑改善”（6.5%，基线时焦虑较高，随后下降）。与始终非焦虑的女性相比，始终焦虑的女性更有可能报告基线时疲劳、抑郁和文化适应压力；焦虑改善的女性更有可能报告基线时疲劳、抑郁和妊娠前的抑郁史。在 12-24 周时，13.8%的焦虑改善女性寻求精神保健服务，而始终焦虑的女性为 8.6%，始终非焦虑的女性为 4.7%（p=0.06）。
我们的样本由中国移民和加拿大出生的女性组成；结果应在其他人群中进行复制。
我们确定了产后焦虑轨迹的 3 个亚组。这些女性群体可能因暴露于各种风险因素组合而对干预措施有不同的反应。
