临床妊娠诊断 Zika 病毒感染与产后抑郁症症状表现的关联：病例对照研究。
Implications of the clinical gestational diagnosis of ZIKV infection in the manifestation of symptoms of postpartum depression: a case-control study.
机构信息
School of Medicine, Federal University of Goiás- UFG, Av. Primeira Avenida, s/n, Setor Leste Universitário, Goiânia, GO, 74605-020, Brazil.
, Avenida Getúlio Vargas, 663, Aragarças, GO, 76240-000, Brazil.
出版信息
BMC Psychiatry. 2019 Jun 26;19(1):199. doi: 10.1186/s12888-019-2157-9.
BACKGROUND
Traumatic events can trigger postpartum depression. Pregnant women in Brazil today are facing an extremely stressful experience. Thus, the objective here was to analyze the prevalence of symptoms of depression in the immediate postpartum period (IPPD) and associate these symptoms with previous stressful, social, psychological, behavioral, obstetrical, clinical, violent and infectious events, particularly exposure to Zika virus (ZIKV) infection during pregnancy.
METHODS
This was a case-control study. The sample comprised 213 puerperal women treated in the maternity ward of a public reference hospital in the Araguaia River Valley of Mato Grosso and Goiás, Brazil. Severe IPPD symptoms were confirmed based on the Edinburgh Postnatal Depression Scale (EPDS). A descriptive statistical analysis was carried out using the Epi Info™ version 7.1.5 suite of software tools and the Statistical Package for Social Sciences (SPSS) version 21.0.
RESULTS
A bivariate analysis revealed a significant association between "severe symptoms of IPPD" and the following variables: "clinical diagnosis of ZIKV during pregnancy" (OR = 13.36; 95% CI = 5.34-33.39); "was separated or divorced in the last year" (OR = 3.58; 95% CI = 1.42-8.99); "suffered an accident in the last year" (OR = 3.32, 95% CI = 1.12-9.82); "suffered emotional violence during pregnancy" (OR = 3.80; 95% CI = 1.81-7.99); "suffered physical violence during pregnancy" (OR = 11.86; 95% CI = 2.07-67.82); "fear of her partner" (OR = 17.90; 95% CI = 3.44-92.99); "dengue fever during pregnancy" (OR = 7.85; 95% CI: 1.66-37.05), and "has a family member diagnosed with mental illness" (OR = 2.54; 95% CI = 1.09-5.93). The multivariate analysis confirmed the association of severe PPD symptoms only with the variables of "clinical diagnosis of ZIKV during pregnancy" (OR = 19.82; 95% CI: 5.35-73.39) and "was separated or divorced in the last year" (OR = 3.92; 95% IC = 1.12-13.63).
CONCLUSIONS
Clinically diagnosed ZIKV during pregnancy may be one of the main events associated with severe IPPD symptoms, showing an almost 20-fold higher chance of occurrence than other factors.
背景
创伤性事件可引发产后抑郁症。如今，巴西的孕妇正面临着极其紧张的经历。因此，本研究旨在分析产后即刻期（IPPD）抑郁症状的流行率，并将这些症状与之前的压力、社会、心理、行为、产科、临床、暴力和感染事件相关联，特别是在怀孕期间接触寨卡病毒（ZIKV）感染。
方法
这是一项病例对照研究。样本包括 213 名在巴西马托格罗索州和戈亚斯州阿拉瓜亚河流域一家公立参考医院的产科病房接受治疗的产妇。使用爱丁堡产后抑郁量表（EPDS）确认严重 IPPD 症状。使用 Epi Info ™ 版本 7.1.5 套件软件工具和社会科学统计软件包（SPSS）版本 21.0 进行描述性统计分析。
结果
单变量分析显示，“严重的 IPPD 症状”与以下变量之间存在显著关联：“怀孕期间临床诊断为 ZIKV”（OR=13.36；95%CI=5.34-33.39）；“去年离婚或分居”（OR=3.58；95%CI=1.42-8.99）；“去年遭遇事故”（OR=3.32，95%CI=1.12-9.82）；“怀孕期间遭受情绪暴力”（OR=3.80；95%CI=1.81-7.99）；“怀孕期间遭受身体暴力”（OR=11.86；95%CI=2.07-67.82）；“害怕她的伴侣”（OR=17.90；95%CI=3.44-92.99）；“怀孕期间患登革热”（OR=7.85；95%CI：1.66-37.05），以及“有家庭成员被诊断患有精神疾病”（OR=2.54；95%CI=1.09-5.93）。多变量分析仅确认了严重 PPD 症状与“怀孕期间临床诊断 ZIKV”（OR=19.82；95%CI：5.35-73.39）和“去年离婚或分居”（OR=3.92；95%IC=1.12-13.63）变量之间的关联。
结论
在怀孕期间临床诊断的 ZIKV 可能是与严重 IPPD 症状相关的主要事件之一，其发生的可能性几乎是其他因素的 20 倍。
Zotero 插件