随机试验研究运动和健康干预对预防产后抑郁和感知压力的影响。
Randomized trial examining the effect of exercise and wellness interventions on preventing postpartum depression and perceived stress.
作者信息
Lewis Beth A, Schuver Katie, Dunsiger Shira, Samson Lauren, Frayeh Amanda L, Terrell Carrie A, Ciccolo Joseph T, Fischer John, Avery Melissa D
机构信息
University of Minnesota, School of Kinesiology, 1900 University Ave SE, Minneapolis, MN, 55455, USA.
Center for Health Promotion and Health Equity in the Department of Behavioral and Social Sciences, Brown University, Box G-S121-4, Providence, RI, 02912, USA.
出版信息
BMC Pregnancy Childbirth. 2021 Nov 22;21(1):785. doi: 10.1186/s12884-021-04257-8.
BACKGROUND
Approximately 13-19% of postpartum women experience postpartum depression and a majority report at least some stress during the postpartum phase. Traditional interventions such as psychotherapy and antidepressant medications are often not feasible or desirable. The purpose of this study was to examine two low cost, brief, accessible interventions designed to prevent postpartum depression and perceived stress among women at high risk.
METHODS
Participants (n = 450) who were on average four weeks postpartum, had a history of depression before pregnancy, and exercised less than 60 min per week were randomly assigned to one of the following three conditions: (1) 6-month telephone-based exercise intervention; (2) 6-month telephone-based wellness/support intervention (e.g., healthy eating, sleep, and perceived stress); or (3) usual care.
RESULTS
Overall, 2.4% of participants met criteria for depression at 6 months and 3.6% at 9 months with no differences between groups. At 6 months following randomization, median symptoms of depression were significantly lower among wellness participants compared to usual care participants (b = - 1.00, SE = 0.46, p = .03). Perceived stress at 6 months post-randomization was significantly lower among exercise vs. usual care participants (b = - 2.00, SE = .98, p = .04) and exercise vs. wellness participants (b = - 2.20, SE = 1.11, p = .04).
CONCLUSIONS
The wellness intervention was efficacious for preventing symptoms of depression; however, postpartum depression that met the diagnostic criteria was surprisingly low in all conditions among this at risk sample of postpartum women. Exercise interventions may have a protective effect on perceived stress among women at risk for postpartum depression. Practitioners should consider integrating exercise and wellness interventions into postpartum care.
TRIAL REGISTRATION
Clinical Trials Number: NCT01883479 (06/21/2013).
背景
大约有 13-19%的产后女性会经历产后抑郁症，大多数女性在产后阶段都会感到至少有一些压力。传统的干预方法，如心理治疗和抗抑郁药物，往往不可行或不理想。本研究的目的是检验两种低成本、简短、易于获得的干预措施，以预防有产后抑郁风险的女性产后抑郁和感知压力。
方法
参与者（n=450）平均产后四周，在怀孕前有抑郁史，每周运动少于 60 分钟，随机分配到以下三种情况之一：（1）为期 6 个月的电话基础运动干预；（2）为期 6 个月的电话基础健康/支持干预（如健康饮食、睡眠和感知压力）；或（3）常规护理。
结果
总体而言，2.4%的参与者在 6 个月时符合抑郁标准，3.6%的参与者在 9 个月时符合抑郁标准，各组之间无差异。在随机分组后 6 个月，健康组参与者的抑郁症状中位数明显低于常规护理组（b=-1.00，SE=0.46，p=0.03）。在随机分组后 6 个月时，运动组与常规护理组相比，感知压力明显较低（b=-2.00，SE=0.98，p=0.04），运动组与健康组相比，感知压力也明显较低（b=-2.20，SE=1.11，p=0.04）。
结论
健康干预对预防抑郁症状有效；然而，在所有条件下，该高风险产后女性样本中，符合诊断标准的产后抑郁症发生率却出奇地低。运动干预可能对有产后抑郁风险的女性的感知压力有保护作用。从业者应考虑将运动和健康干预纳入产后护理。
试验注册
临床试验编号：NCT01883479（2013 年 6 月 21 日）。
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