Puppo Soledad, Cormick Gabriela, Gibbons Luz, Rodríguez Rocio, Correa Malena, Smith José, Marroquín Victoria, Rozic Pablo, Belizán José M, Schvartzman Javier A, Daray Federico M
Universidad de Buenos Aires, Facultad de Medicina, Instituto de Farmacología, Paraguay 2155, piso 9 (C1121ABG), Ciudad Autónoma de Buenos Aires, Argentina.
Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Emilio Ravignani 2024 (C1414CPV), Ciudad Autónoma de Buenos Aires, Argentina.; Departamento de Salud, Universidad Nacional de La Matanza (UNLAM), San Justo 1903, Argentina.
J Psychosom Res. 2022 Apr;155:110748. doi: 10.1016/j.jpsychores.2022.110748. Epub 2022 Feb 3.
This study explores postpartum depression (PPD) in women who screened negative in mid-pregnancy to assess the impact of the peripartum period on the development of depressive symptoms.
A prospective cohort study was carried out in two facilities in Argentina. The Edinburgh postnatal depression scale (EPDS) scale was applied to pregnant women between weeks 20-24 gestation, and those screening negative (<10) were included in the cohort. Participants were followed up until the 4th week postpartum, when the EPDS was repeated. If positive, a semi-structured clinical interview was applied (MINI) to define the diagnosis.
A total of 112 pregnant women were eligible for the follow-up. At the 4th week postpartum, 14 women (12.5%, CI 95% 7.0; 20.1) screened positive using a cutoff point of 10 or more in the EPDS. Of those screened positive in the EPDS, two participants (1.8%, CI 95% 0.2-6.3) had a Major Depressive Disorder. Newborn admission to the Intensive Care Unit, hospitalization of the newborn after discharge, abuse during childbirth, and lack of company during labor were identified as peripartum risk factors.
This study reinforces the relevance of women and newborn mental health care during the hospitalization process surrounding peripartum. The women and newborn hospitalization process should be better explored to understand the contribution to PPD and design and test strategies to alleviate the impact of maternal depression.
本研究探讨孕期筛查为阴性的女性产后抑郁症（PPD），以评估围产期对抑郁症状发展的影响。
在阿根廷的两个机构开展了一项前瞻性队列研究。对妊娠20 - 24周的孕妇应用爱丁堡产后抑郁量表（EPDS），筛查为阴性（<10）的孕妇纳入队列。对参与者进行随访至产后第4周，再次应用EPDS。若结果为阳性，则应用半结构化临床访谈（MINI）来明确诊断。
共有112名孕妇符合随访条件。产后第4周，14名女性（12.5%，95%置信区间7.0；20.1）在EPDS中使用10分及以上的临界值筛查为阳性。在EPDS筛查为阳性的患者中，两名参与者（1.8%，95%置信区间0.2 - 6.3）患有重度抑郁症。新生儿入住重症监护病房、出院后新生儿住院、分娩时受虐以及分娩时无人陪伴被确定为围产期危险因素。
本研究强化了围产期住院期间女性和新生儿心理健康护理的重要性。应更好地探究女性和新生儿的住院过程，以了解其对产后抑郁症的影响，并设计和测试减轻产妇抑郁影响的策略。
