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唇腭裂患儿母亲的产后抑郁

Postpartum Depression in Mothers of Infants With Cleft Lip and/or Palate.

作者信息

Johns Alexis L, Hershfield Jennifer A, Seifu Netsanet Mulugeta, Haynes Karla A

机构信息

Division of Plastic and Maxillofacial Surgery.

University of Southern California University Center of Excellence in Developmental Disabilities, Children's Hospital Los Angeles, Los Angeles, CA.

出版信息

J Craniofac Surg. 2018 Jun;29(4):e354-e358. doi: 10.1097/SCS.0000000000004319.

Abstract

This study describes postpartum depression rates and risk factors for mothers with infants with cleft lip and/or palate as postpartum depression has been associated with a range of negative maternal and child outcomes. A retrospective chart review from August 2009 to May 2015 included medical diagnoses, demographics, receipt of prenatal diagnosis, and the Edinburgh Postnatal Depression Scale (EPDS). Mothers (N = 206) had infants (59.2% male; mean age in weeks 5.1 ± 6.9) with isolated cleft lip (18%), cleft palate (22.8%), or cleft lip and palate (59.2%). Mothers ranged from 16 to 45 years old (mean age 29 ± 6.2) and half had received a prenatal diagnosis. Patients mostly had public insurance (57.8%) and represented diverse ethnicities. Based on the EPDS, 11.7% of mothers met the depression cutoff of 10 or higher. The majority endorsed self-blame (68.9%), difficulty coping (59.2%), and feeling anxious (57.3%). Mothers of infants with cleft lip or cleft lip and palate who did not receive a prenatal diagnosis had higher total EPDS scores, anxiety, and incidence of feeling scared. Higher EPDS scores were predicted by not having a prenatal diagnosis and by older maternal age. Mothers of infants with a cleft had similar rates of postpartum depression as the general population; however, those who were older and who did not receive a prenatal diagnosis endorsed more symptoms. Prenatal diagnosis may contribute to positive maternal postpartum adjustment. Providers should incorporate screening for risk factors into their evaluation and treatment planning.

摘要

本研究描述了唇腭裂患儿母亲的产后抑郁发生率及风险因素,因为产后抑郁与一系列不良母婴结局相关。对2009年8月至2015年5月的病历进行回顾性分析,内容包括医学诊断、人口统计学资料、产前诊断情况以及爱丁堡产后抑郁量表(EPDS)。母亲们(N = 206)的婴儿中,59.2%为男性;平均年龄为5.1±6.9周,患有单纯唇裂(18%)、腭裂(22.8%)或唇腭裂(59.2%)。母亲年龄在16至45岁之间(平均年龄29±6.2岁),其中半数接受了产前诊断。患者大多拥有公共保险(57.8%),且来自不同种族。根据EPDS,11.7%的母亲达到了抑郁临界值10分及以上。大多数人认可自责(68.9%)、难以应对(59.2%)和感到焦虑(57.3%)。未接受产前诊断的唇裂或唇腭裂患儿母亲的EPDS总分、焦虑程度及感到害怕的发生率更高。未进行产前诊断和母亲年龄较大可预测较高的EPDS得分。唇腭裂患儿母亲的产后抑郁发生率与普通人群相似;然而,年龄较大且未接受产前诊断的母亲表现出更多症状。产前诊断可能有助于母亲产后的积极调适。医疗服务提供者应在评估和治疗计划中纳入风险因素筛查。

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