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孕期抑郁症及其药物治疗对母婴结局的影响。

Effect of Depressive Disorders and Their Pharmacological Treatment during Pregnancy on Maternal and Neonatal Outcome.

作者信息

Parpinel Giulia, Rosso Gianluca, Galante Arianna, Germano Chiara, Aragno Elena, Girlando Flavia, Messina Alessandro, Laudani Maria Elena, Rolfo Alessandro, Attini Rossella, Revelli Alberto, Maina Giuseppe, Masturzo Bianca

机构信息

Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.

Psychiatric Unit, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043 Orbassano, Italy.

出版信息

J Clin Med. 2022 Mar 9;11(6):1486. doi: 10.3390/jcm11061486.

Abstract

Depressive disorders are related to obstetrical and neonatal complications. The purpose of this study is to evaluate the outcomes of pregnancy in women suffering from depressive disorders, who are treated or not treated with pharmacotherapy during pregnancy. The maternal and neonatal outcomes of 281 pregnant women with depressive disorders (D group-DG), who delivered their babies at Sant'Anna Hospital of Turin, were compared with those of a control group of 200 depression-free, healthy, pregnant women, who were matched for maternal age (C group-CG). Of the depressed patients, those who received pharmacotherapy during pregnancy (DG-Tr, = 199, 70.8%) were compared with those who did not (DG-Untr, = 82, 29.2%). The comparisons were performed using χ tests for categorical variables and ANOVA for continuous variables. A linear regression analysis was run to examine the association between APGAR scores at 5 min and certain clinical variables. The women in DG showed higher rates of cesarean section, preterm delivery, induction of labor and SGA babies, and low neonatal weights and 5-min APGAR scores, compared to the untreated patients. Those treated with psychotropic drugs showed lower rates of cesarean section, but lower 5-min APGAR scores, compared to those who were untreated. However, after controlling for confounding variables, the 5-min APGAR scores were linearly associated with neonatal weight and not with the use of psychotropic treatment. No significant differences were observed between the treated and untreated women, regarding the rates of preterm delivery, induction of labor, SGA and low neonatal weight. In pregnant patients with depressive disorders, poorer outcomes are expected vs. healthy controls. Pharmacological treatment is associated with a reduced rate of cesarean section, without inducing other complications for the mother and the newborn.

摘要

抑郁症与产科及新生儿并发症有关。本研究的目的是评估患有抑郁症的女性在孕期接受或未接受药物治疗的妊娠结局。将在都灵圣安娜医院分娩的281名患有抑郁症的孕妇(D组-DG)的母婴结局与200名年龄匹配的无抑郁症、健康孕妇的对照组(C组-CG)进行比较。在抑郁症患者中,将孕期接受药物治疗的患者(DG-Tr,n = 199,70.8%)与未接受药物治疗的患者(DG-Untr,n = 82,29.2%)进行比较。使用χ检验对分类变量进行比较,使用方差分析对连续变量进行比较。进行线性回归分析以检验5分钟时的阿氏评分与某些临床变量之间的关联。与未治疗的患者相比,DG组的女性剖宫产、早产、引产和小于胎龄儿的发生率更高,新生儿体重低且5分钟阿氏评分低。与未治疗的患者相比,接受精神药物治疗的患者剖宫产率较低,但5分钟阿氏评分较低。然而,在控制混杂变量后,5分钟阿氏评分与新生儿体重呈线性相关,与精神药物治疗的使用无关。在早产、引产、小于胎龄儿和低出生体重发生率方面,治疗组和未治疗组女性之间未观察到显著差异。与健康对照组相比,患有抑郁症的孕妇预期结局较差。药物治疗与剖宫产率降低相关,且不会给母亲和新生儿带来其他并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ae/8948944/13c9f4ea66bb/jcm-11-01486-g001.jpg

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