Departamento de Medicina Preventiva I Hospital das Clinicas HCFMUSP I Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Faculdade de Medicina, Universidade Federal de Uberlândia, Minas Gerais, Brazil.
Int J Gynaecol Obstet. 2021 Jun;153(3):469-475. doi: 10.1002/ijgo.13593. Epub 2021 Feb 20.
To estimate prenatal depression underdiagnosis prevalence and its associated sociodemographic and obstetric risk factors among a population-based sample of Brazilian pregnant women with depression.
We used data from the Brazilian National Survey (PNS 2013). Of the 22 445 women of reproductive age, 800 reported being pregnant. Participants answered the Patient Health Questionnaire-9 (PHQ-9) and a questionnaire with sociodemographic, obstetric, and clinical data. Classification of prenatal depression underdiagnosis was made using the comparison between results obtained from the self-referred question evaluating clinical diagnosis of depression and the results of the PHQ-9. Pregnant women with a PHQ-9 score greater than 8 and with a "No" answer in the clinical question were classified as prenatal depression underdiagnosis. Logistic regression models were performed to obtain crude and adjusted odds ratios (OR) between variables and prenatal depression underdiagnosis.
Prevalence of prenatal depression underdiagnosis was 82.3% (74.8%-87.8%). Pregnant women with non-white skin color and pregnant women with an elementary school degree were more likely to be underdiagnosed with prenatal depression in comparison with women with white skin color (adjusted OR 2.42, 95% confidence interval [CI] 0.99-5.91) and with women with higher education (adjusted OR 4.07, 95% CI 2.05-8.09).
Equitable mental health assistance for pregnant women should considered prenatal depression social risk factors.
评估在巴西具有抑郁症状的孕妇人群中，产前抑郁漏诊的流行率及其相关的社会人口学和产科风险因素。
我们使用了巴西国家调查（PNS 2013）的数据。在 22445 名育龄妇女中，有 800 名报告怀孕。参与者回答了患者健康问卷-9（PHQ-9）和一份包含社会人口学、产科和临床数据的问卷。通过将自我报告的评估临床抑郁诊断的问题的结果与 PHQ-9 的结果进行比较，对产前抑郁漏诊进行分类。PHQ-9 得分大于 8 分且临床问题回答“否”的孕妇被归类为产前抑郁漏诊。使用逻辑回归模型得出变量与产前抑郁漏诊之间的粗比值比（OR）和调整比值比（aOR）。
产前抑郁漏诊的患病率为 82.3%（74.8%-87.8%）。与皮肤白皙的女性（调整后的 OR 2.42，95%置信区间 [CI] 0.99-5.91）和受教育程度较高的女性（调整后的 OR 4.07，95% CI 2.05-8.09）相比，非白人皮肤颜色和小学学历的孕妇更有可能被漏诊为产前抑郁。
应考虑产前抑郁的社会风险因素，为孕妇提供公平的心理健康援助。
