Department of Population and Quantitative Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
Graduate School of Nursing, University of Massachusetts Medical School, Worcester, Massachusetts.
Womens Health Issues. 2019 Jul-Aug;29(4):333-340. doi: 10.1016/j.whi.2019.04.008. Epub 2019 May 16.
Depression is the most commonly diagnosed medical condition among women veterans ages 18 to 44; however, depression symptoms occurring during pregnancy have not been well-studied in this population.
Pregnant veterans were recruited from 15 Veterans Health Administration sites across the United States; our sample included 501 participants. Sociodemographic characteristics, military service, health status, and pregnancy related factors, as well as the Edinburgh Postnatal Depression Scale (EPDS), were collected as part of a telephone survey. Additional data were obtained from electronic health record data. We used multivariable logistic regression models to examine factors associated with an EPDS score suggestive of clinically significant depressive symptoms (≥10).
Prenatal EPDS scores of 10 or greater were calculated for 28% of our sample. Our final model indicated that factors associated with decreased odds of an EPDS score of 10 or greater included spousal or partner support during pregnancy (adjusted odds ratio [aOR], 0.35; 95% confidence interval [CI], 0.16-0.77) and employment (aOR, 0.40; 95% CI, 0.24-0.67). A past diagnosis of anxiety (aOR, 2.54; 95% CI, 1.43-4.50), past antidepressant use (aOR, 3.27; 95% CI, 1.71-6.24), and active duty service (aOR, 1.91; 95% CI, 1.08-3.37) were associated with increased odds of having an EPDS score of 10 or greater.
This is the first quantitative estimate of depression symptoms in pregnant veterans across multiple Veterans Affairs facilities. The prevalence of depression symptomology was greater than the high end of prevalence estimates in the general pregnant population. Given that the risk of depression increases during the postpartum period, women who can be identified with depressive symptomatology during pregnancy can be offered critical resources and support before giving birth.
在 18 至 44 岁的女性退伍军人中，抑郁是最常见的诊断性医学疾病；然而，在该人群中，怀孕期间出现的抑郁症状尚未得到充分研究。
从美国 15 个退伍军人健康管理局的站点招募了孕妇退伍军人；我们的样本包括 501 名参与者。作为电话调查的一部分，收集了社会人口统计学特征、兵役、健康状况和与怀孕相关的因素，以及爱丁堡产后抑郁量表（EPDS）。从电子健康记录数据中获得了额外的数据。我们使用多变量逻辑回归模型来检查与 EPDS 得分提示临床显著抑郁症状（≥10）相关的因素。
我们样本中 28%的人产前 EPDS 评分达到 10 或更高。我们的最终模型表明，与 EPDS 评分达到 10 或更高的可能性降低相关的因素包括怀孕期间配偶或伴侣的支持（调整后的优势比[aOR]，0.35；95%置信区间[CI]，0.16-0.77）和就业（aOR，0.40；95% CI，0.24-0.67）。过去被诊断为焦虑症（aOR，2.54；95% CI，1.43-4.50）、过去使用抗抑郁药（aOR，3.27；95% CI，1.71-6.24）和现役服役（aOR，1.91；95% CI，1.08-3.37）与 EPDS 评分达到 10 或更高的可能性增加相关。
这是首次对多个退伍军人事务设施中孕妇的抑郁症状进行定量估计。抑郁症状的患病率高于一般孕妇人群的高患病率估计值。鉴于产后期间抑郁风险增加，在分娩前可以为出现抑郁症状的女性提供关键资源和支持。
