Obstet Gynecol. 2018 Nov;132(5):e208-e212. doi: 10.1097/AOG.0000000000002927.
Perinatal depression, which includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery, is one of the most common medical complications during pregnancy and the postpartum period, affecting one in seven women. It is important to identify pregnant and postpartum women with depression because untreated perinatal depression and other mood disorders can have devastating effects. Several screening instruments have been validated for use during pregnancy and the postpartum period. The American College of Obstetricians and Gynecologists recommends that obstetrician-gynecologists and other obstetric care providers screen patients at least once during the perinatal period for depression and anxiety symptoms using a standardized, validated tool. It is recommended that all obstetrician-gynecologists and other obstetric care providers complete a full assessment of mood and emotional well-being (including screening for postpartum depression and anxiety with a validated instrument) during the comprehensive postpartum visit for each patient. If a patient is screened for depression and anxiety during pregnancy, additional screening should then occur during the comprehensive postpartum visit. There is evidence that screening alone can have clinical benefits, although initiation of treatment or referral to mental health care providers offers maximum benefit. Therefore, clinical staff in obstetrics and gynecology practices should be prepared to initiate medical therapy, refer patients to appropriate behavioral health resources when indicated, or both.
围产期抑郁症,包括在怀孕期间或分娩后 12 个月内发生的重度和轻度抑郁发作,是怀孕期间和产后最常见的医学并发症之一,影响每七名妇女中的一人。识别患有抑郁症的孕妇和产后妇女非常重要,因为未经治疗的围产期抑郁症和其他情绪障碍可能会产生毁灭性的影响。已经有几种筛选工具在怀孕期间和产后得到了验证。美国妇产科医师学会建议,妇产科医生和其他产科护理提供者至少应使用标准化、经过验证的工具,在围产期期间对每位患者的抑郁和焦虑症状进行一次筛查。建议所有妇产科医生和其他产科护理提供者在每位患者的全面产后访视期间,对情绪和情感健康进行全面评估(包括使用经过验证的工具筛查产后抑郁症和焦虑症)。如果在怀孕期间对患者进行了抑郁和焦虑症筛查,则应在全面产后访视期间再次进行筛查。有证据表明,单独筛查就可以带来临床益处,尽管开始治疗或转介到心理健康护理提供者那里会带来最大的益处。因此,妇产科实践中的临床工作人员应准备好开始进行医学治疗,在必要时将患者转介到适当的行为健康资源,或同时进行这两项操作。