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孕期抑郁症状的变化:一项来自孟加拉国的队列研究。

Changes in Depressive Symptoms During the Antenatal Period: A Cohort Study from Bangladesh.

作者信息

Begum Musammet Rasheda, Biswas Soma Chowdhury

机构信息

Dept. of Agricultural Economics and Social Sciences, Chattogram Veterinary and Animal Sciences University, Khulshi, Chattogram, Bangladesh.

Dept. of Statistics, University of Chittagong, Hathazari, Chattogram, Bangladesh.

出版信息

Indian J Psychol Med. 2020 Oct 20;42(6):519-524. doi: 10.1177/0253717620954337. eCollection 2020 Nov.

Abstract

BACKGROUND

Antenatal depressive symptoms adversely affect the health and well-being of women, babies, and their families. This study aimed to explore the prevalence and probable associated factors of depressivse symptoms.

METHODS

A prospective cohort approach was adopted, and 435 pregnant women were assessed longitudinally at an antenatal clinic in the first, second, and third trimesters. Edinburgh Postnatal Depression Scale (EPDS) was used to measure self-reported depressive symptoms. The multivariate approach of the general linear model was used to evaluate the mean differences of depression scores among the trimesters. To investigate the associated factors of depressive symptoms, generalized estimating equation (GEE) was used to take into account the clustering effect.

RESULTS

More than half (58.13%) of the pregnant women had antenatal depressive symptoms in at least one trimester. Depressive symptoms decreased throughout the pregnancy; they were higher in the first trimester and declined toward the third trimester. Significant mean differences were found in depression scores among the three trimesters. GEE showed that trimester, education, family income, and body mass index (BMI) are significantly associated with antenatal depressive symptoms.

CONCLUSIONS

First trimester is the most critical period for identification of depressive symptoms. At-risk women need to be treated. Proper education achievement, economic solvency, and adequate nutrition could reduce the depressive symptoms.

摘要

背景

产前抑郁症状会对女性、婴儿及其家庭的健康和幸福产生不利影响。本研究旨在探讨抑郁症状的患病率及可能的相关因素。

方法

采用前瞻性队列研究方法,对435名孕妇在产前诊所进行了孕早期、孕中期和孕晚期的纵向评估。使用爱丁堡产后抑郁量表(EPDS)来测量自我报告的抑郁症状。采用一般线性模型的多变量方法来评估各孕期抑郁评分的均值差异。为了调查抑郁症状的相关因素,使用广义估计方程(GEE)来考虑聚类效应。

结果

超过一半(58.13%)的孕妇在至少一个孕期出现产前抑郁症状。抑郁症状在整个孕期呈下降趋势;在孕早期较高,并在孕晚期逐渐下降。三个孕期的抑郁评分存在显著的均值差异。GEE显示,孕期、教育程度、家庭收入和体重指数(BMI)与产前抑郁症状显著相关。

结论

孕早期是识别抑郁症状的最关键时期。高危女性需要接受治疗。适当的教育程度、经济偿付能力和充足的营养可以减轻抑郁症状。

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