Department of Psychiatry, Oxford University, Oxford, UK.
Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil.
J Affect Disord. 2020 Apr 15;267:315-324. doi: 10.1016/j.jad.2020.02.025. Epub 2020 Feb 10.
We utilised data from the 2015 Pelotas Birth Cohort, a large prospective cohort in southern Brazil, to examine the association of moderate and severe antenatal depression with child birth outcomes and explore interactions with sociodemographic characteristics.
Data was available for n = 3046 participants and their infants. We measured antenatal depression using the Edinburgh Postnatal Depression Scale (EPDS, ≥13 for moderate and ≥17 for severe depression). Outcome measures included gestational age, birth weight, length and head circumference, using the Intergrowth-21st standards. We controlled for known confounders including obstetric risk.
We did not find differences in childbirth outcomes by maternal depression status for participants with at least moderate depression, although there was an increased risk for female offspring to be small for gestational age (SGA, OR 2.33[1.37,3.97]). For severe depression (EPDS≥17) we found an increased risk for lower APGAR scores (OR 1.63[1.02,2.60]) and being SGA (OR 1.77[1.06,2.97], with an increased risk for female offspring in particular to be in lower weight centiles (-10.71 [-16.83,-4.60]), to be SGA (OR 3.74[1.89, 7.44]) and in the lower 10th centile for length (OR 2.19[1.25,3.84]).
include the use of a maternal report questionnaire to ascertain depressive symptoms.
In this recent large longitudinal cohort in Brazil we did not find independent effects of depression on adverse birth outcomes or interactions with sociodemographic characteristics. We found an increased risk of being SGA for female offspring of women with moderate and severe depression, in line with other research suggesting females may be more susceptible to antenatal disturbances.
This work was supported by the Wellcome Trust, United Kingdom (095582), the Brazilian National Research Council (CNPq) and the Coordination for the Improvement of Higher Education Personnel (CAPES). EN was supported by the UK Economic and Social Research Council GCRF Postdoctoral Fellowship (ES/P009794/1).
我们利用了来自巴西南部 2015 年佩洛塔斯出生队列的大型前瞻性队列的数据,来研究中度和重度产前抑郁症与分娩结局的关系,并探讨与社会人口特征的相互作用。
数据可用于 n=3046 名参与者及其婴儿。我们使用爱丁堡产后抑郁量表(EPDS,≥13 分为中度,≥17 分为重度)来测量产前抑郁症。结局测量包括使用 Intergrowth-21 标准的胎龄、出生体重、身长和头围。我们控制了已知的混杂因素,包括产科风险。
对于至少有中度抑郁的参与者,我们没有发现产妇抑郁状态与分娩结局的差异,但女性后代有较小胎龄的风险增加(OR 2.33[1.37,3.97])。对于重度抑郁(EPDS≥17),我们发现较低的阿普加评分(OR 1.63[1.02,2.60])和较小胎龄的风险增加(OR 1.77[1.06,2.97]),尤其是女性后代体重百分位数较低(-10.71 [-16.83,-4.60]),较小胎龄(OR 3.74[1.89,7.44])和长度的第 10 百分位数较低(OR 2.19[1.25,3.84])。
包括使用母亲报告问卷来确定抑郁症状。
在巴西最近的这项大型纵向队列研究中,我们没有发现抑郁对不良分娩结局的独立影响,也没有发现与社会人口特征的相互作用。我们发现,患有中度和重度抑郁症的女性后代发生小胎龄的风险增加,这与其他研究表明女性可能更容易受到产前干扰的结果一致。
这项工作得到了英国惠康信托基金会(095582)、巴西国家研究理事会(CNPq)和高等教育人员改进协调会(CAPES)的支持。EN 得到了英国经济和社会研究理事会全球研究奖学金(ES/P009794/1)的支持。