Gachon University, Department of Social Welfare, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13120, Republic of Korea.
Helen Bader School of Social Work, University of Wisconsin-Milwaukee, United States.
J Affect Disord. 2022 Mar 15;301:44-51. doi: 10.1016/j.jad.2022.01.026. Epub 2022 Jan 4.
The current study aimed to describe and predict perinatal depression trajectories in a sample of low-income women from the first trimester of pregnancy to six months postpartum.
The study sample consisted of 899 women in Wisconsin who received home visiting services. Eligible participants were screened for depressive symptoms by home visitors using the Edinburgh Postnatal Depression Scale at least three times across four time periods from the first trimester of pregnancy to six months postpartum. Growth Mixture Modeling was applied to identify distinct trajectory classes, and multinomial logistic regressions were performed to analyze predictors of class membership.
Mean depressive symptom scores in this racially/ethnically diverse sample of low-income women decreased significantly over time from a high of 8.1 at time1 to a low of 6.8 at time4. Four classes were identified, including a low-stable group (78.2% of sample), a high-stable group (10.6%) along with decreasing (7.1%) and increasing (4.1%) trajectories. Women with a history of abuse and mental health difficulties were more likely to be classified in the high-stable and decreasing depression groups than the low-stable group. Low social support was linked to an increasing trajectory that resulted in high levels of postpartum depression.
Although most women exhibited stable and positive trajectories, more than one out of five presented with either persistently or intermittently high depression scores. Taken together, the findings underscore the importance of depression screening throughout the perinatal period and identifying factors that may be used to target resources to at-risk populations.
本研究旨在描述并预测低收入孕妇群体的围产期抑郁轨迹，研究对象为从妊娠早期至产后 6 个月的 899 名女性。
威斯康星州的研究参与者接受家访服务，家访人员使用爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale）对其进行至少 3 次抑郁症状筛查，筛查时间点横跨妊娠早期至产后 6 个月的 4 个时期。采用增长混合模型（Growth Mixture Modeling）识别不同的轨迹类别，采用多项逻辑回归分析（Multinomial logistic regressions）来分析类别归属的预测因素。
在这个种族/民族多样化的低收入孕妇样本中，抑郁症状评分从妊娠早期的 8.1 分（时间 1）显著下降至产后 6 分（时间 4）。研究共识别出 4 个类别，包括低稳定组（78.2%的样本）、高稳定组（10.6%）以及下降组（7.1%）和上升组（4.1%）。有虐待和精神健康问题史的女性更有可能被归类于高稳定和下降抑郁组，而非低稳定组。低社会支持与上升轨迹相关，导致产后抑郁程度较高。
虽然大多数女性表现出稳定和积极的轨迹，但仍有五分之一以上的女性表现出持续或间歇性的高抑郁评分。综上所述，这些发现强调了在围产期进行抑郁筛查的重要性，并确定了可能用于针对高危人群的资源的因素。
