Tebeka Sarah, Le Strat Yann, Etain Bruno, Ray Margaux, Mullaert Jimmy, Dubertret Caroline
Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neurosciences, Team 1, Paris, France.
Department of Psychiatry, AP-HP, Louis Mourier Hospital, F-92700, Colombes, France.
J Clin Psychiatry. 2021 Sep 7;82(5):20m13664. doi: 10.4088/JCP.20m13664.
Childhood trauma (CT) is associated with an increased risk of major depressive disorder, but little is known about the impact of CT on depression during pregnancy and the early and late postpartum period. The present study assesses whether CT is associated with perinatal depression, considering different types of CT. This study used data from the Interaction of Gene and Environment of Depression in PostPartum (IGEDEPP), a French multicenter prospective cohort study, including 3,252 women who completed the Childhood Trauma Questionnaire at the maternity department between November 2011 and June 2016. Depression during pregnancy was assessed retrospectively at the maternity department using criteria. Early- and late-onset postpartum depression were assessed at 2 months and 1 year postpartum, respectively. Among the 3,252 women, 298 (9.2%) reported at least 1 CT. Women with CT had a higher risk of depression (OR = 2.2; 95% CI, 1.7-2.7), anxiety (OR = 2.3; 95% CI, 1.7-3.0), and suicide attempts (OR = 5.4; 95% CI, 3.5-8.4) than women without CT. Perinatal depression was more frequent in women with CT than in women without CT, after adjustment for sociodemographic characteristics and personal history of major depressive episode and consideration of the timing of onset (pregnancy, early or late postpartum) ( < .001). There was a dose effect between the number of CT types and the risk of perinatal depression. These results show that CT is associated with a depressive episode during adulthood, specifically in the perinatal period. These findings may lead to special prenatal care for women abused or neglected during childhood, to better screen and treat perinatal depression. ClinicalTrials.gov identifier: NCT01648816.
童年创伤（CT）与重度抑郁症风险增加相关，但关于CT对孕期以及产后早期和晚期抑郁症的影响知之甚少。本研究评估CT是否与围产期抑郁症相关，并考虑不同类型的CT。本研究使用了来自法国多中心前瞻性队列研究“产后抑郁症的基因与环境相互作用”（IGEDEPP）的数据，该研究包括2011年11月至2016年6月期间在产科完成童年创伤问卷的3252名女性。孕期抑郁症在产科通过标准进行回顾性评估。产后早期和晚期抑郁症分别在产后2个月和1年进行评估。在这3252名女性中，298名（9.2%）报告至少经历过一次CT。与未经历CT的女性相比，经历CT的女性患抑郁症（OR = 2.2；95% CI，1.7 - 2.7）、焦虑症（OR = 2.3；95% CI，1.7 - 3.0）和自杀未遂（OR = 5.4；95% CI，3.5 - 8.4）的风险更高。在调整社会人口学特征、重度抑郁发作个人史并考虑发病时间（孕期、产后早期或晚期）后，经历CT的女性围产期抑郁症比未经历CT的女性更常见（p <.001）。CT类型数量与围产期抑郁症风险之间存在剂量效应。这些结果表明，CT与成年期抑郁发作相关，特别是在围产期。这些发现可能会促使为童年期受虐待或被忽视的女性提供特殊的产前护理，以更好地筛查和治疗围产期抑郁症。ClinicalTrials.gov标识符：NCT01648816。
