Acheampong Kwabena, Pan Xiongfeng, Kaminga Atipatsa Chiwanda, Wen Shi Wu, Liu Aizhong
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, 410078, China; Department of Public Health, Adventist University of Africa, Kenya; Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, 410078, China.
J Psychiatr Res. 2021 Apr;136:32-38. doi: 10.1016/j.jpsychires.2021.01.036. Epub 2021 Jan 21.
Pregnancy is a time of increased vulnerability for the development of anxiety and depression. The purpose of this study was to compare the risk of developing adverse maternal and perinatal outcomes between pregnant women with moderate-severe depression and those who had mild depression.
Our study was performed in a prospective cohort of 360 depressed pregnant women, recruited and followed up to delivery at the Adventist Hospital in Bekwai Municipality, Ghana. The research began in February 2020 and the follow-up was completed in August 2020. The pregnant women who had depression were classified into two groups: those who had moderate-severe depression (Patient Health Questionnaires-9 (PHQ-9) score ≥15) and those who had mild depression (PHQ-9 score <15). Crude and adjusted relative risk (RR) with their corresponding 95% confidence intervals (95% CIs) for women with moderate-severe depression as compared with women with mild depression were then estimated.
Out of a total of 360 pregnant women, 43 (11.9%) screened positive for moderate-severe depression. After adjusting for potential confounders, women with moderate-severe depression during pregnancy, as compared with women who had mild depression had an increased risk of pre-eclampsia (RR = 2.01; 95% CI:1.21-3.33); Caesarean section (RR = 1.78; 95% CI:1.18-2.70); and episiotomy (RR = 1.66; 95% CI: 1.06-2.60). On the other hand, no statistically significant association of severity of depression and perinatal outcomes was observed.
Compared with mild depression, symptoms of moderate-severe depression in pregnancy significantly increased risks of adverse maternal outcomes such as pre-eclampsia, caesarean section delivery, and episiotomy.
孕期是焦虑和抑郁发生风险增加的时期。本研究的目的是比较中重度抑郁症孕妇与轻度抑郁症孕妇发生不良孕产妇和围产期结局的风险。
我们的研究在加纳贝奎市基督复临安息日会医院进行，对360名抑郁孕妇进行前瞻性队列研究，招募并随访至分娩。研究于2020年2月开始，随访于2020年8月完成。患有抑郁症的孕妇被分为两组：中重度抑郁症患者（患者健康问卷-9（PHQ-9）评分≥15）和轻度抑郁症患者（PHQ-9评分<15）。然后估计中重度抑郁症女性与轻度抑郁症女性相比的粗相对风险（RR）及其相应的95%置信区间（95%CI）。
在总共360名孕妇中，43名（11.9%）筛查出中重度抑郁症呈阳性。在对潜在混杂因素进行校正后，孕期患有中重度抑郁症的女性与患有轻度抑郁症的女性相比，发生子痫前期的风险增加（RR = 2.01；95%CI：1.21 - 3.33）；剖宫产（RR = 1.78；95%CI：1.18 - 2.70）；以及会阴切开术（RR = 1.66；95%CI：1.06 - 2.60）。另一方面，未观察到抑郁症严重程度与围产期结局之间存在统计学上的显著关联。
与轻度抑郁症相比，孕期中重度抑郁症症状显著增加了子痫前期、剖宫产分娩和会阴切开术等不良孕产妇结局的风险。
