围产期抑郁症：风险与诊断状况是否会影响母婴结合和感知到的社会支持？
Peripartum depression: Does risk versus diagnostic status impact mother-infant bonding and perceived social support?
机构信息
Department of Psychology, Center for Children and Families, Florida International University, Miami, Florida, USA.
VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA.
出版信息
Depress Anxiety. 2021 Apr;38(4):390-399. doi: 10.1002/da.23121. Epub 2020 Dec 7.
BACKGROUND
Peripartum depression (PND) impairs mother-infant boding and perceived social support, yet limited research has examined if women at-risk for PND (AR-PND) also experience impairment. We examined if pregnant women AR-PND, women with PND, and healthy comparison women (HCW) differed in their mother-infant bonding and social support. As PND is highly comorbid with anxiety, we also examined if peripartum anxiety impacted postpartum diagnosis of PND.
METHODS
A total of 144 pregnant women AR-PND or euthymic were assessed twice antepartum and twice postpartum. We utilized regression models to examine the impact of PND risk group status and diagnostic status on mother-infant bonding and perceived social support postpartum. We conducted a sensitivity analysis using a generalized estimating equations model to determine if anxiety (Hamilton Anxiety Rating Scale, HAM-A) across all four time points was associated with the postpartum diagnosis of PND.
RESULTS
Women AR-PND experienced significantly worse mother-infant bonding compared to HCW (p = .03). Women diagnosed with PND experienced significantly worse mother-infant bonding and social support compared to HCW (p = .001, p = .002, respectively) and to those who were at-risk for but did not develop PND (p = .02, p = .008, respectively). HAM-A severity at each visit was associated with PND diagnosis status, where each increase in HAM-A was associated with 15% increased odds of being diagnosed with PND postpartum.
CONCLUSIONS
Both women AR-PND and those with PND experience worse mother-infant bonding. Peripartum anxiety should also be assessed as it represents a marker for later PND.
背景
围产期抑郁症（PND）会损害母婴联系和感知到的社会支持，但有限的研究调查了是否有患 PND 风险的女性（AR-PND）也存在这种损害。我们检查了 AR-PND 的孕妇、患有 PND 的女性和健康对照组女性（HCW）在母婴联系和社会支持方面是否存在差异。由于 PND 与焦虑症高度共病，我们还检查了围产期焦虑是否会影响产后 PND 的诊断。
方法
共有 144 名 AR-PND 或心境正常的孕妇在产前和产后各评估了两次。我们利用回归模型来检查 PND 风险组状况和诊断状况对产后母婴联系和感知社会支持的影响。我们使用广义估计方程模型进行了敏感性分析，以确定四个时间点的焦虑（汉密尔顿焦虑量表，HAM-A）是否与产后 PND 的诊断有关。
结果
与 HCW 相比，AR-PND 的女性母婴联系明显更差（p = .03）。与 HCW 相比，被诊断为 PND 的女性母婴联系和社会支持明显更差（p = .001，p = .002），与有但未发展为 PND 的 AR-PND 女性相比也更差（p = .02，p = .008）。每次就诊时 HAM-A 的严重程度与 PND 的诊断状况有关，每次 HAM-A 的增加与产后诊断为 PND 的几率增加 15%有关。
结论
AR-PND 女性和患有 PND 的女性的母婴联系都更差。围产期焦虑也应进行评估，因为它是 PND 后期的一个标志物。
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