Matsuoka Hideki, Iwami Shuichiro, Maeda Marisa, Suizu Ai, Fujii Tsuyoshi
Department of Gynecology and Obstetrics, Kyoto Katsura Hospital, Kyoto, Japan.
Department of Gynecology and Obstetrics, Rakuwakai Otowa Hospital, Kyoto, Japan.
J Obstet Gynaecol Res. 2021 Feb;47(2):508-514. doi: 10.1111/jog.14540. Epub 2020 Nov 4.
Most Japanese institutions screen for post-partum depression (PPD) using the Edinburgh Postnatal Depression Scale (EPDS) at outpatient visits conducted at 2- and 4-week post-partum, but there are no published data on the usefulness of EPDS scores 2-week post-partum. In the present study, relationships between 2-week post-partum EPDS scores and 4-week post-partum EPDS scores were investigated to determine whether 2-week scores may facilitate early intervention in high-risk mothers.
A retrospective analysis of 451 deliveries from 2017 to 2019 was conducted at a single institution. EPDS scores were obtained using the Japanese EPDS 2- and 4-week post-partum, in conjunction with other perinatal data from medical records.
In total, 334 of 451 mothers (74.1%) completed the EPDS at both 2- and 4-week post-partum and were included in the analysis. Of 48 who had higher scores 2-week post-partum, 21 (43.8%) continued to be at high risk of PPD. Of 284 who had lower scores 2-week post-partum, 9 (3.2%) transitioned to scores indicating high risk. Women considered high-risk 4-week post-partum tended to have exhibited higher scores 2-week post-partum. Women who had experienced more deliveries tended to exhibit lower scores, and psychiatric illness was strongly associated with higher EPDS scores (odds ratio 11.2, 95% confidence interval 3.7-33.8, P < 0.01).
Two-week EPDS scores closely reflected 4-week scores, and may facilitate early intervention to prevent PPD. Primiparous mothers and those with a history of psychiatric illness should be followed-up closely.
大多数日本机构在产后2周和4周的门诊就诊时使用爱丁堡产后抑郁量表(EPDS)筛查产后抑郁症(PPD),但尚无关于产后2周EPDS评分有效性的公开数据。在本研究中,调查了产后2周EPDS评分与产后4周EPDS评分之间的关系,以确定2周评分是否有助于对高危母亲进行早期干预。
对一家机构2017年至2019年的451例分娩进行回顾性分析。在产后2周和4周使用日本版EPDS获得评分,并结合病历中的其他围产期数据。
451名母亲中共有334名(74.1%)在产后2周和4周均完成了EPDS,并纳入分析。产后2周评分较高的48名母亲中,21名(43.8%)继续处于PPD高危状态。产后2周评分较低的284名母亲中,9名(3.2%)转变为高危评分。产后4周被认为高危的女性在产后2周往往表现出较高的评分。分娩次数较多的女性往往表现出较低的评分,精神疾病与较高的EPDS评分密切相关(比值比11.2,95%置信区间3.7-33.8,P < 0.01)。
产后2周的EPDS评分与4周评分密切相关,可能有助于预防PPD的早期干预。初产妇和有精神疾病史的产妇应密切随访。