School of Nursing and Midwifery, University of Newcastle, Callaghan Campus, University Drive, Callaghan, NSW, 2308, Australia.
University of Newcastle Priority Research Centre for Reproductive Science: Mothers and Babies, Callaghan, Australia.
Matern Child Health J. 2020 Jun;24(6):718-726. doi: 10.1007/s10995-020-02906-6.
During the perinatal period, 10-20% of women experience anxiety and/or depression. Untreated perinatal depression has the potential for adverse effects on the family and infant resulting in long-term deleterious consequences. This study measured the association between self-reported depression using the Edinburgh Postnatal Depression Scale scores, self-reported anxiety and neonatal birth outcomes.
A retrospective design was used with ObstetriX™ data retrieved from 16 metropolitan and rural hospitals in NSW, Australia during 2009-2014. Data were available for 53,646 singleton births. The Edinburgh Postnatal Depression Scale was used to identify self-reported depression while women self-reported pregnancy related anxiety. Regression modelling measured the effects of self-reported depression and self-reported pregnancy related anxiety on neonatal birth outcomes. Linear regression and logistic regression were used to model the effect on birth weight, gestational age, admission to NICU or the SCN, outcome (stillborn vs livebirth), and Apgar scores. Cox proportional hazards regression was used to estimate the effect on neonatal length of stay.
Babies born to women self-reporting anxiety were more likely to have birth complications, be admitted to the nursery, had lower Apgar scores and longer hospital stays. Babies born to women self-identifying as experiencing a level of depression were more likely to have a lower birth weight, shorter gestational age, and, lower Apgar score. These babies were more likely to be admitted to the nursery with an increased length of stay.
Perinatal anxiety and depression contribute to poor birth outcomes. Early detection of maternal perinatal anxiety and depression is an important step towards treatment interventions. More research is needed to identify models of care that are effective in identifying and managing perinatal depression and anxiety to improve birth outcomes for women and their babies.
在围产期，10-20%的女性会经历焦虑和/或抑郁。未经治疗的围产期抑郁有可能对家庭和婴儿产生不利影响，导致长期的有害后果。本研究通过爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale）评分来衡量报告的抑郁、报告的焦虑与新生儿出生结局之间的关联。
本研究采用回顾性设计，使用澳大利亚新南威尔士州 16 家大都市和农村医院的 ObstetriX™数据，时间为 2009-2014 年。共有 53646 名单胎分娩的产妇数据。采用爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale）来识别报告的抑郁，同时产妇报告与妊娠相关的焦虑。回归模型衡量了报告的抑郁和与妊娠相关的焦虑对新生儿出生结局的影响。线性回归和逻辑回归用于对出生体重、胎龄、新生儿重症监护病房或特殊护理新生儿病房（Special Care Nursery）的入住、结局（死产与活产）和阿普加评分进行建模。Cox 比例风险回归用于估计对新生儿住院时间的影响。
报告焦虑的女性所生婴儿更有可能出现分娩并发症、入住新生儿病房，其阿普加评分较低，住院时间更长。报告有抑郁程度的女性所生婴儿更有可能体重较低、胎龄较短，且阿普加评分较低。这些婴儿更有可能入住新生儿病房，住院时间更长。
围产期焦虑和抑郁会导致不良的分娩结局。早期发现产妇围产期的焦虑和抑郁是进行治疗干预的重要步骤。需要进一步研究，以确定有效的护理模式，以便识别和管理围产期的抑郁和焦虑，从而改善妇女及其婴儿的分娩结局。
