如果怀孕不是天堂般的美好呢？孕期和分娩期特定生活事件对产前焦虑和抑郁向产后焦虑和抑郁转化的影响。
What If Pregnancy Is Not Seventh Heaven? The Influence of Specific Life Events during Pregnancy and Delivery on the Transition of Antenatal into Postpartum Anxiety and Depression.
机构信息
Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
Department of Clinical Psychology, University of Groningen, 3584 CS Groningen, The Netherlands.
出版信息
Int J Environ Res Public Health. 2019 Aug 9;16(16):2851. doi: 10.3390/ijerph16162851.
INTRODUCTION
Postpartum symptoms of anxiety and depression are known to have a negative impact on mother and child, and major life events constitute a major risk factor for these symptoms. We aimed to investigate to what extent specific life events during pregnancy, delivery complications, unfavorable obstetric outcomes, and antenatal levels of anxiety or depression symptoms were independently associated with postpartum levels of anxiety and depression symptoms.
METHODS
Within a prospective population-based cohort study ( = 3842) in The Netherlands, antenatal symptoms of anxiety or depression were measured at the end of the first trimester and at five months postpartum. Antenatal life events were assessed during the third trimester, and information on delivery and obstetric outcomes was obtained from midwives and gynecologists. Linear regression analyses were performed to quantify the associations.
RESULTS
Antenatal levels of both anxiety and depression symptoms were associated with postpartum levels of anxiety and depression symptoms. Life events related to health and sickness of self or loved ones, to the relation with the partner or conflicts with loved ones, or to work, finance, or housing problems were significantly associated with higher postpartum levels of anxiety symptoms ( < 0.001) and depression symptoms ( < 0.001) adjusted for antenatal levels. No statistically significant results were observed for pregnancy-related events, delivery complications, or unfavorable obstetric outcomes.
CONCLUSIONS
Women with increased antenatal levels of anxiety or depression symptoms are at increased risk of elevated levels of both postpartum depression and anxiety symptoms. Experiencing life events during pregnancy that were not related to the pregnancy was associated with higher levels of anxiety and depression in the postpartum period, as opposed to pregnancy-related events, delivery complications, or unfavorable obstetric outcomes. These results suggest that events during pregnancy but not related to the pregnancy and birth are a highly important predictor for postpartum mental health.
简介
产后焦虑和抑郁症状已知会对母婴产生负面影响，重大生活事件是这些症状的主要危险因素。我们旨在调查怀孕期间的特定生活事件、分娩并发症、不良产科结局以及产前的焦虑或抑郁症状水平在多大程度上与产后的焦虑和抑郁症状水平独立相关。
方法
在荷兰一项前瞻性基于人群的队列研究（n=3842）中，在妊娠第一期末和产后五个月测量产前的焦虑或抑郁症状。在妊娠晚期评估产前生活事件，从中助产士和妇科医生获取分娩和产科结局的信息。采用线性回归分析来量化相关性。
结果
产前的焦虑和抑郁症状水平与产后的焦虑和抑郁症状水平相关。与自身或亲人的健康和疾病、与伴侣的关系或与亲人的冲突、或与工作、财务或住房问题有关的生活事件与较高的产后焦虑症状水平（<0.001）和抑郁症状水平（<0.001）显著相关，调整了产前水平。与妊娠相关的事件、分娩并发症或不良产科结局无统计学显著结果。
结论
产前焦虑或抑郁症状水平升高的女性产后抑郁和焦虑症状水平升高的风险增加。在怀孕期间经历与妊娠无关的生活事件与产后更高水平的焦虑和抑郁相关，而与妊娠相关的事件、分娩并发症或不良产科结局相反。这些结果表明，怀孕期间但与妊娠和分娩无关的事件是产后心理健康的一个非常重要的预测因素。
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