Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel.
BMJ Open. 2021 Nov 9;11(11):e052873. doi: 10.1136/bmjopen-2021-052873.
Maternal perinatal depression is a common phenomenon, influencing infants' development. Studies have shown an inconsistent association between perinatal depression and healthcare resource utilisation. This study aimed to assess whether perinatal depression in mothers is associated with their infants' healthcare utilisation, during the first 2 years of life.
A cohort study based on computerised medical records.
Nationwide primary care clinics in the second largest health maintenance organisation in Israel.
593 children of women with depression (the exposed group) and 2310 children of women without depression.
Primary outcome variables included general practitioner/paediatrician (GP/Paed) visits (regular and telehealth), emergency room (ER) visits, hospital admission rates and child-development clinic visits. Secondary outcomes included antibiotic use and anaemia status. The exposure variable, perinatal depression, was based on Edinburgh Postnatal Depression Scale. A score of ≥10 was classified as depression.
Multivariable analysis of the number of regular visits and telehealth to the GP/Paed showed an adjusted incidence rate ratio (aIRR) of 1.08, 95% CI 1.03 to 1.13 and aIRR 0.95, 95% CI 0.82 to 1.10, respectively. Children of mothers with perinatal depression had more hospital admissions (aIRR 1.21, 95% CI 1.01 to 1.46) and more visits to child development clinics (aIRR 1.33, 95% CI 1.04 to 1.70). There was a non-significant increase in ER visits (IRR 1.26, 95% CI 0.66 to 2.42), and non-significant decrease in antibiotics prescriptions (IRR 0.95, 95% CI 0.86 to 1.05) and anaemia status (IRR 0.93, 95% CI 0.72 to 1.20).
This study shows higher health services utilisation among children of mothers with perinatal depression, including regular GP/Paed visits, hospital admission rates, and child-development clinics.
围产期抑郁是一种常见现象，会影响婴儿的发育。研究表明，围产期抑郁与医疗资源利用之间的关联并不一致。本研究旨在评估母亲围产期抑郁是否与婴儿在生命的头 2 年的医疗保健利用有关。
基于计算机医疗记录的队列研究。
以色列第二大健康维护组织的全国初级保健诊所。
593 名患有抑郁症的妇女的孩子（暴露组）和 2310 名没有抑郁症的妇女的孩子。
主要结局变量包括全科医生/儿科医生（GP/Paed）就诊（常规和远程医疗）、急诊室（ER）就诊、住院率和儿童发育诊所就诊。次要结局包括抗生素使用和贫血状况。围产期抑郁的暴露变量基于爱丁堡产后抑郁量表。得分≥10 分被归类为抑郁。
对全科医生/儿科医生常规就诊和远程医疗就诊次数的多变量分析显示，调整后的发病率比（aIRR）分别为 1.08（95%CI 1.03 至 1.13）和 0.95（95%CI 0.82 至 1.10）。患有围产期抑郁症母亲的孩子住院率更高（aIRR 1.21，95%CI 1.01 至 1.46），儿童发育诊所就诊次数更多（aIRR 1.33，95%CI 1.04 至 1.70）。急诊室就诊次数（IRR 1.26，95%CI 0.66 至 2.42）略有增加，但抗生素处方（IRR 0.95，95%CI 0.86 至 1.05）和贫血状况（IRR 0.93，95%CI 0.72 至 1.20）略有下降。
本研究显示，患有围产期抑郁症母亲的孩子更需要利用医疗服务，包括常规全科医生/儿科医生就诊、住院率和儿童发育诊所就诊。
