产后抑郁症与婴儿疫苗接种率之间无关联：以色列大型健康维护组织数据库中的一项匹配队列研究
No Association Between Maternal Post-partum Depression and Vaccination Uptake of Infants: A Matched Cohort Study in a Large Health Maintenance Organization Database in Israel.
作者信息
Zaikin Ariela, Koren Gideon, Chodick Gabriel, Grossman Zachi
机构信息
Department of Clinical Pharmacy, Faculty of Medicine, School of Pharmacy, Hebrew University of Jerusalem, Jerusalem, Israel.
Department of Pharmacy, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
出版信息
Front Pediatr. 2022 Feb 8;9:771089. doi: 10.3389/fped.2021.771089. eCollection 2021.
BACKGROUND
Maternal post-partum depression is one of the most common medical complications around childbirth. One of its consequences is a possible association with children's receipt of preventive health care, including immunization. This study aimed to explore the association between maternal postpartum depression and children's immunization rates.
METHODS
A retrospective cohort study of Maccabi Healthcare Services (HMO) members comparing immunization rates between children born between 2006 and 2019 to mothers with post-partum depression and children born to mothers with no documented depression. Post-partum depression was assessed by Edinburgh Postnatal Depression Scale, a 10-item questionnaire considered the screening tool of choice in Israel for early Post-partum detection. 1:1 matching was conducted according to criteria: age of the mother ± 2 years, child's year of birth, the newborn baby's gender, the baby's birth order and socioeconomic index. The primary outcome was defined as non-vaccination and the exposure was defined as depression. A sub-analysis was performed, comparing immunization rates of children born to mothers treated with antidepressant medications to rates of children born to untreated mothers.
RESULTS
A total of 709 subjects in the exposed cohort (children born to mothers with post-partum depression symptoms) and 681 subjects in the matched cohort were analyzed. The relative risks among children born to depressed mothers compared with children born to healthy mothers for not receiving any vaccine at 2 months, three doses of pertussis vaccine up to 7 months and four doses of DTaP-Hib-IPV vaccine up to 18 months were 1.15 (95% CI 0.74-1.78), 1.11 (95% CI 0.94-1.31) and 0.82 (95% CI 0.56-1.95), respectively. The relative risks among 139 infants born to treated mothers compared with 570 infants born to untreated mothers for not receiving any vaccine at 2 months, three doses of pertussis vaccine up to 7 months and four doses of DTaP-Hib-IPV vaccine up to 18 months were 1.28 (0.64-2.54), 0.78 (0.57-1.06) and 0.42 (0.17-1.03), respectively.
CONCLUSION
We found no significant association between maternal post-partum depression and uptake of child Immunization.
背景
产后抑郁症是分娩前后最常见的医学并发症之一。其后果之一可能是与儿童接受预防性医疗保健（包括免疫接种）有关。本研究旨在探讨产后抑郁症与儿童免疫接种率之间的关联。
方法
对Maccabi医疗服务机构（健康维护组织）的成员进行一项回顾性队列研究，比较2006年至2019年出生的患有产后抑郁症母亲的孩子与未记录有抑郁症母亲的孩子的免疫接种率。产后抑郁症通过爱丁堡产后抑郁量表进行评估，这是一份10项问卷，被认为是以色列早期产后检测的首选筛查工具。根据以下标准进行1:1匹配：母亲年龄±2岁、孩子出生年份、新生儿性别、婴儿出生顺序和社会经济指数。主要结局定义为未接种疫苗，暴露因素定义为抑郁症。进行了一项亚分析，比较了接受抗抑郁药物治疗的母亲所生孩子与未接受治疗的母亲所生孩子的免疫接种率。
结果
共分析了暴露队列中的709名受试者（患有产后抑郁症症状母亲所生的孩子）和匹配队列中的681名受试者。与健康母亲所生孩子相比，抑郁症母亲所生孩子在2个月时未接种任何疫苗、7个月时未接种三剂百日咳疫苗以及18个月时未接种四剂白喉-破伤风-无细胞百日咳-流感嗜血杆菌-灭活脊髓灰质炎疫苗的相对风险分别为1.15（95%可信区间0.74-1.78）、1.11（95%可信区间0.94-1.31）和0.82（95%可信区间0.56-1.95）。与570名未接受治疗母亲所生婴儿相比，139名接受治疗母亲所生婴儿在2个月时未接种任何疫苗、7个月时未接种三剂百日咳疫苗以及18个月时未接种四剂白喉-破伤风-无细胞百日咳-流感嗜血杆菌-灭活脊髓灰质炎疫苗的相对风险分别为1.28（0.64-2.54）、0.78（0.57-1.06）和0.42（0.17-1.03）。
结论
我们发现产后抑郁症与儿童免疫接种率之间无显著关联。
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