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产前抑郁症:医疗补助计划参与者的评估和结果。

Prenatal Depression: Assessment and Outcomes among Medicaid Participants.

机构信息

Urban Institute, Washington, DC, USA.

Center for Medicare and Medicaid Innovation, Baltimore, Maryland, USA.

出版信息

J Behav Health Serv Res. 2020 Jul;47(3):409-423. doi: 10.1007/s11414-020-09689-2.

Abstract

This study used bivariate and regression-adjusted analyses of participant-level survey and medical data to investigate prevalence of depression among pregnant Medicaid participants, correlates of depression, and the relationship between depression and pregnancy outcomes. The sample included Medicaid participants with a single gestation and valid depression data who were enrolled in Strong Start for Mothers and Newborns 2, a national preterm birth prevention program, from 2013 to 2017 (N = 37,287; 85% of total enrollment). Depression rates in Strong Start were high (27.5%). Depression was associated with being black; having other children, an unplanned pregnancy, or challenges accessing prenatal care; not having a co-resident spouse or partner; and experiencing intimate partner violence. After these and other risk factors were controlled for, depression remained associated with higher rates of preterm birth. Systematic screening and holistic approaches to prenatal care that address depression and associated risks could help reduce rates of preterm birth and other poor pregnancy outcomes.

摘要

本研究采用双变量和回归调整分析参与者层面的调查和医疗数据,调查了在 Medicaid 参与者中怀孕的人中抑郁的流行率、抑郁的相关因素,以及抑郁与妊娠结局之间的关系。该样本包括参加 Strong Start for Mothers and Newborns 2 的 Medicaid 参与者,这是一个全国性的早产预防计划,他们在 2013 年至 2017 年期间有单胎妊娠和有效的抑郁数据(N=37287;占总入学人数的 85%)。Strong Start 的抑郁率很高(27.5%)。抑郁与以下因素有关:是黑人;有其他孩子、计划外怀孕或难以获得产前护理;没有共同居住的配偶或伴侣;以及经历过亲密伴侣暴力。在控制了这些和其他风险因素后,抑郁仍然与较高的早产率有关。系统的筛查和整体的产前保健方法,解决抑郁和相关风险,可能有助于降低早产率和其他不良妊娠结局的发生率。

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