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孕期抑郁症状与低出生体重的关联:一项前瞻性研究。

The association between symptoms of depression during pregnancy and low birth weight: a prospective study.

机构信息

Nanshan Maternity & Child Healthcare Hospital of Shenzhen, Shenzhen, China.

Sun Yat-Sen University, Guangzhou, China.

出版信息

BMC Pregnancy Childbirth. 2020 Mar 6;20(1):147. doi: 10.1186/s12884-020-2842-1.

Abstract

BACKGROUND

Most studies have showed that maternal depression is associated with pregnancy complications. However, there were limited evidences in Chinese population. We examined the associations of antenatal depression symptoms with pregnancy outcomes, especially for low birth weight.

METHODS

A total of 1377 singleton pregnant women were recruited from Nanshan Maternity & Child Healthcare Hospital of Shenzhen in this prospective cohort study. Depression symptoms were assessed by the Edinburgh postnatal depression scale (EPDS) questionnaire in the second trimester of gestation; cut-points for the indication of antenatal depression were ≧12 scores in this study. Socio-demographic data, life-style and pregnancy outcomes were collected through Shenzhen Maternity & Child Healthcare database. The risks of adverse outcomes in pregnant women with antenatal depression were determined by multivariate logistic regression and represented as odds ratio(OR) and 95% confidence interval (CI).

RESULTS

Of the 1377 subjects, the prevalence of antenatal depression was 19.1%. The EPDS scores were 13.8 ± 2.0 and 6.5 ± 2.9 (P < 0.001) in subjects with and without antenatal depression, respectively. After adjustment for maternal age, education, parity, pre-pregnancy body mass index (BMI), residential area, fetal gender, an EPDS score ≥ 12 (versus. < 12) was associated with an increased risk for low birth weight (odds ratio: 2.05, 95% CI: 1.12-4.64), but not for preterm birth, large for gestational age, small for gestational age or macrosomia.

CONCLUSION

Pregnant women presenting antenatal depressive symptoms are at elevated risk of low birth weight. Mental health problems of pregnancy should be addressed for the prevention of low birth weight.

摘要

背景

大多数研究表明,母亲的抑郁与妊娠并发症有关。然而,在中国人群中,证据有限。我们研究了产前抑郁症状与妊娠结局的关系,特别是与低出生体重的关系。

方法

这项前瞻性队列研究共纳入了 1377 名来自深圳南山妇幼保健院的单胎孕妇。在妊娠中期使用爱丁堡产后抑郁量表(EPDS)问卷评估抑郁症状;本研究中,产前抑郁的指标为得分≧12 分。通过深圳妇幼保健数据库收集社会人口统计学数据、生活方式和妊娠结局。采用多变量 logistic 回归确定有产前抑郁的孕妇不良结局的风险,并表示为比值比(OR)和 95%置信区间(CI)。

结果

在 1377 名受试者中,产前抑郁的患病率为 19.1%。有产前抑郁和无产前抑郁的孕妇 EPDS 评分分别为 13.8±2.0 和 6.5±2.9(P<0.001)。在校正了母亲年龄、教育程度、产次、孕前体重指数(BMI)、居住地区、胎儿性别后,EPDS 评分≧12(与<12 分相比)与低出生体重的风险增加相关(比值比:2.05,95%置信区间:1.12-4.64),但与早产、巨大儿、小于胎龄儿或巨大儿无关。

结论

出现产前抑郁症状的孕妇发生低出生体重的风险增加。应重视孕妇的心理健康问题,以预防低出生体重。

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