Epidemiology, Biostatistics & Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue W, Room 27, Montreal, QC, H3A 1A2, Canada.
School of Public Health, University of Saskatchewan, 104 Clinic Place, Health Sciences Building, Room 3338, Saskatoon, SK, S7N 2Z4, Canada.
Arch Womens Ment Health. 2018 Dec;21(6):689-698. doi: 10.1007/s00737-018-0845-y. Epub 2018 Apr 13.
The aim of this study is to identify subgroups of women who exhibit distinct trajectory patterns of depressive and anxiety disorders from pregnancy to early postpartum and the risk factors associated with the latent trajectory group memberships. Women (n = 615) from the Feelings in Pregnancy and Motherhood (FIP) longitudinal study were followed from early pregnancy to early postpartum for a 7-month period in 2006-2007. The semi-parametric group-based trajectory modeling approach was used to identify the latent trajectory groups. Multinomial logit models were then used to explore the association between latent trajectory group membership and antenatal characteristics. We identified four latent trajectory groups of perinatal depressive symptoms: "low-stable" (49.6%), "moderate-stable" (42.3%), "postpartum" (3.6%), and "antepartum" (4.6%). Significant risk factors associated with these trajectory group memberships were past depression, stress level, ethnicity, the mother's age, and relationship satisfaction. Three latent trajectory groups of perinatal anxiety symptoms were identified: "very low-stable" (8.9%); "low-stable" (60.7%); and "moderate-stable" (30.4%). Significant risk factor associated with these trajectories were past depression, stress level, and income level. Latent trajectory groups of perinatal depressive and anxiety symptoms were identified to uncover potential heterogeneity in populations. Our findings support the need for multiple assessments starting from early pregnancy to the postpartum, which can give some important insights on the characteristics of the women at high symptom burden trajectories for early interventions that may alter the progress of their mental symptoms.
本研究旨在确定从怀孕到产后早期出现不同抑郁和焦虑障碍轨迹模式的女性亚组，以及与潜在轨迹群体成员身份相关的风险因素。2006-2007 年， Feelings in Pregnancy and Motherhood（FIP）纵向研究的 615 名女性从早期妊娠开始至产后 7 个月进行了随访。使用半参数基于群组的轨迹建模方法来确定潜在轨迹组。然后使用多项逻辑回归模型来探讨潜在轨迹组成员身份与产前特征之间的关系。我们确定了产前抑郁症状的四个潜在轨迹组：“低稳定”（49.6%）、“中稳定”（42.3%）、“产后”（3.6%）和“产前”（4.6%）。与这些轨迹组成员身份相关的显著风险因素包括既往抑郁、压力水平、种族、母亲年龄和关系满意度。还确定了产前焦虑症状的三个潜在轨迹组：“极低稳定”（8.9%）、“低稳定”（60.7%）和“中稳定”（30.4%）。与这些轨迹相关的显著风险因素是既往抑郁、压力水平和收入水平。确定产前抑郁和焦虑症状的潜在轨迹组可以揭示人群中的潜在异质性。我们的研究结果支持从早期妊娠开始到产后进行多次评估的必要性，这可以为处于高症状负担轨迹的女性特征提供一些重要的见解，以便进行早期干预，从而可能改变她们的精神症状进展。
