Lau Ying, Htun Tha Pyai, Kwong Ho Keung Dennis
Department of Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
School of Health Sciences, Macao Polytechnic Institutes, Macao Special Administrative Region of the People's Republic of China, China.
PLoS One. 2018 Feb 8;13(2):e0188365. doi: 10.1371/journal.pone.0188365. eCollection 2018.
This study aimed (1) to investigate the pattern of perinatal depressive symptoms, and (2) to determine the relationships between sociodemographic characteristics, obstetric factors, antenatal morbidities, postnatal conditions, and perinatal depressive symptoms using a structural equation model (SEM).
A three-wave prospective longitudinal design was used for 361 women in their second trimester, third trimester, and at six weeks postpartum. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms.
The intensity of depressive symptoms was the highest in the second trimester among the three waves. The SEM showed that unmarried status, unplanned pregnancy, gestational diabetes, and headache were significantly associated with EPDS in the first and second waves. The EPDS in the first wave was able to predict the EPDS in the second and third waves. The SEM has satisfactorily fit with the data (chi-square/degree of freedom = 1.42, incremental fit index = 0.91, Tucker-Lewis index = 0.90, comparative fit index = 0.91, and root mean square error of approximation = 0.03).
The findings highlight the significance of monitoring depressive symptoms in the second trimester. Findings from this study could be useful in the design of effective intervention among women with unmarried status, unplanned pregnancy, gestational diabetes, and headache in order to reduce risk of perinatal depressive symptoms.
本研究旨在（1）调查围产期抑郁症状模式，以及（2）使用结构方程模型（SEM）确定社会人口学特征、产科因素、产前疾病、产后状况与围产期抑郁症状之间的关系。
采用三波前瞻性纵向设计，对361名处于孕中期、孕晚期和产后六周的女性进行研究。使用爱丁堡产后抑郁量表（EPDS）评估抑郁症状。
在这三波研究中，孕中期抑郁症状的强度最高。结构方程模型显示，未婚状态、意外怀孕、妊娠期糖尿病和头痛在第一波和第二波中与爱丁堡产后抑郁量表得分显著相关。第一波的爱丁堡产后抑郁量表得分能够预测第二波和第三波的得分。该结构方程模型与数据拟合良好（卡方/自由度 = 1.42，增值拟合指数 = 0.91，塔克 - 刘易斯指数 = 0.90，比较拟合指数 = 0.91，近似误差均方根 = 0.03）。
研究结果突出了在孕中期监测抑郁症状的重要性。本研究结果对于设计针对未婚状态、意外怀孕、妊娠期糖尿病和头痛女性的有效干预措施以降低围产期抑郁症状风险可能有用。
