Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands.
Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands.
J Affect Disord. 2021 May 1;286:158-165. doi: 10.1016/j.jad.2021.02.062. Epub 2021 Mar 4.
Depression and anxiety occur frequently postpartum, calling for early detection and treatment. Evidence on risk factors may support early detection, but is inconclusive. Our aim was to identify risk factors for postpartum depression and anxiety, before, during and after pregnancy.
We used data from 1406 mothers of the intervention arm of the Post-Up study. Risk factors were collected at 3 weeks and 12 months postpartum. Depression and anxiety symptoms were measured in the first month postpartum by the Edinburgh Postnatal Depression Scale (EPDS) and 6-item State-Trait Anxiety Inventory (STAI-6), respectively. We used stepwise logistic regression to identify relevant risk factors.
Of the mothers, 8.0% had EPDS-scores ≥9 and 14.7% STAI-6-scores ≥42. Factors associated with higher risk of depression were: foreign language spoken at home, history of depression, low maternal self-efficacy and poor current health of the mother. No initiation of breastfeeding was associated with lower risk of depression, no breastfeeding at 3 weeks postpartum increased the risk. Factors associated with higher risk of anxiety were: higher educational level, history of depression, preterm birth, negative experience of delivery and first week postpartum, excessive infant crying, low maternal self-efficacy, low partner support and poor current maternal health.
Use of a self-report instrument, potential bias by postpartum mood status, and no inclusion of emerging depression cases after one month postpartum.
The shared and separate risk factors for postpartum depression and anxiety may help professionals in identifying mothers at increased risk and provide opportunities for preventive interventions and treatment.
产后常发生抑郁和焦虑，需要早期发现和治疗。有关风险因素的证据可能有助于早期发现，但尚无定论。我们的目的是在妊娠前、妊娠期间和产后确定产后抑郁和焦虑的风险因素。
我们使用了 Post-Up 研究干预组的 1406 位母亲的数据。在产后 3 周和 12 个月时收集风险因素。在产后第一个月使用爱丁堡产后抑郁量表（EPDS）和状态特质焦虑量表 6 项（STAI-6）分别测量抑郁和焦虑症状。我们使用逐步逻辑回归来确定相关的风险因素。
在这些母亲中，有 8.0%的 EPDS 评分≥9，14.7%的 STAI-6 评分≥42。与更高抑郁风险相关的因素有：在家中使用外语、有抑郁病史、母亲自我效能感低和母亲当前健康状况不佳。未开始母乳喂养与更低的抑郁风险相关，产后 3 周时未进行母乳喂养则增加了抑郁风险。与更高焦虑风险相关的因素有：较高的教育水平、有抑郁病史、早产、分娩时的负面经历、产后第一周、婴儿过度哭闹、母亲自我效能感低、伴侣支持度低以及母亲当前健康状况不佳。
使用自我报告工具、产后情绪状态可能存在的偏差，以及未包括产后一个月后出现的新发抑郁病例。
产后抑郁和焦虑的共同和单独风险因素可能有助于专业人员识别风险增加的母亲，并为预防干预和治疗提供机会。
