Institute for Social Science Research, University of Queensland, Brisbane, Queensland, Australia.
Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Women Birth. 2021 Jul;34(4):389-395. doi: 10.1016/j.wombi.2020.06.007. Epub 2020 Jul 1.
Antenatal depression has been associated with poor perinatal outcomes such as preterm birth and low birth weight. Universal screening of perinatal depression has been recommended to improve maternal and pregnancy outcomes.
We hypothesise that screening for antenatal depressive symptoms may reduce the risk of preterm birth and low birth weight. To assess the hypothesis, we explore the association between antenatal depression screening using the Edinburgh Postnatal Depression Scale and neonatal outcomes.
A retrospective analysis of state-wide population-based health administrative data. Inclusion criteria were pregnant women who gave birth to a singleton in Queensland in the second half of 2015 (29,543 women). Logistic regression analyses were run in 27,817 women with information in all variables. Main outcomes were preterm birth (<37 weeks of gestation) and low birth weight (<2500 grs).
Women who did not complete the screening had increased odds of preterm birth (AOR, 1.56; 95% CI, 1.39-1.74; p < 0.001) and low birth weight (AOR, 1.48; 95% CI, 1.30-1.68; p < 0.001) before and after adjustments for relevant confounders when compared to women who completed the screening. Sensitivity analyses performed in women with spontaneous labour and in women without a diagnosis of depression showed similar results.
CONCLUSION(S): We found an association between screening for depressive symptoms during pregnancy and better neonatal outcomes. However, this result does not necessarily infer causality. Any association may represent a previously unknown benefit to screening, which could support the case for universal antenatal depression screening.
产前抑郁与早产和低出生体重等围产期不良结局有关。建议对围产期抑郁进行普遍筛查，以改善母婴和妊娠结局。
我们假设筛查产前抑郁症状可能会降低早产和低出生体重的风险。为了评估这一假设，我们探讨了使用爱丁堡产后抑郁量表进行产前抑郁筛查与新生儿结局之间的关系。
对全州范围的基于人群的健康行政数据进行回顾性分析。纳入标准为 2015 年下半年在昆士兰州分娩的单胎孕妇（29543 名女性）。在有所有变量信息的 27817 名女性中进行逻辑回归分析。主要结局是早产（<37 周妊娠）和低出生体重（<2500 克）。
与完成筛查的女性相比，未完成筛查的女性早产的可能性更高（调整相关混杂因素后的优势比，1.56；95%可信区间，1.39-1.74；p<0.001）和低出生体重（调整相关混杂因素后的优势比，1.48；95%可信区间，1.30-1.68；p<0.001）。在自发性分娩的女性和没有抑郁诊断的女性中进行的敏感性分析显示出类似的结果。
我们发现怀孕期间筛查抑郁症状与更好的新生儿结局之间存在关联。然而，这一结果并不一定表明存在因果关系。任何关联都可能代表筛查的未知益处，这可以支持普遍进行产前抑郁筛查的理由。
