Department of Preventive Medicine, University of São Paulo, Av Dr Arnaldo 455, Room 2214, Sao Paulo, 01246-903, Brazil.
Psychiatr Q. 2021 Jun;92(2):501-511. doi: 10.1007/s11126-020-09813-7.
The objective of the present study is to assess the association of early postpartum depression and maternal confidence with low maternal confidence at 12-15 months after delivery. Prospective study performed from 2013 to 2015 with 358 postpartum women who had participated in a cluster trial to treat their depression during pregnancy. At 6-8 months after birth, we reviewed socio-demographics, obstetric data and Postpartum Depression (PPD) with the Patient Health Questionnaire-9. Maternal Confidence (MC) was assessed at 6-8 and 12-15 months after birth with the Maternal Confidence Questionnaire. Low and High MC was defined using 50% percentile. The crude and adjusted Odds Ratios (OR) with the 95% Confidence Interval (CI) were calculated using Poisson regression with robust variance. Multivariate models estimated the ORs between postpartum depression and LMC at 12-15 months adjusted for socio-demographic variables, maternal characteristics and previous LMC. Statistical analysis was performed with STATA12 and the significance level was considered equal or lower than 5%. Among a sample of women who were depressed during pregnancy, 19% had probably moderate to severe depression, at the beginning of the child' second year of life. Low maternal confidence was associated with previous low maternal confidence (OR = 1.71; 95% CI 1.33:2.20, p = <0.001) and vaginal delivery but not with previous PPD. Based on our findings, detection and treatment of women presenting confidence problems at the first months after delivery may prevent later mother self-efficacy problems.
本研究旨在评估产后早期抑郁和产妇自信心与产后 12-15 个月低产妇自信心之间的关系。这是一项前瞻性研究，于 2013 年至 2015 年进行，共纳入 358 名产后妇女，她们曾参加过一项治疗孕期抑郁的集群试验。产后 6-8 个月，我们通过患者健康问卷-9 回顾了社会人口统计学、产科数据和产后抑郁（PPD）。产后 6-8 个月和 12-15 个月使用产妇信心问卷评估产妇信心（MC）。使用 50%分位数定义低和高 MC。使用 Poisson 回归和稳健方差计算粗比值比（OR）和 95%置信区间（CI）。多变量模型调整了社会人口统计学变量、产妇特征和先前低 MC 后，估计了产后抑郁与 12-15 个月时低 MC 之间的 OR。使用 STATA12 进行统计分析，认为显著性水平等于或低于 5%。在患有孕期抑郁的妇女样本中，有 19%的妇女在孩子两岁初时可能患有中度至重度抑郁。低产妇自信心与先前低产妇自信心（OR=1.71；95%CI 1.33:2.20，p<0.001）和阴道分娩有关，但与先前的 PPD 无关。根据我们的发现，在产后头几个月发现有信心问题的妇女并对其进行检测和治疗，可能预防日后母亲自我效能问题。
