School of Medicine, Oregon Health & Science University, Portland, Oregon, USA.
Division of Neonatology, Oregon Health & Science University, Portland, Oregon, USA.
J Womens Health (Larchmt). 2022 Jun;31(6):772-778. doi: 10.1089/jwh.2021.0428. Epub 2022 Apr 7.
Studies examining the impact of natural disasters noted that in the setting of stable rates of depression, postpartum depression (PPD) increased in vulnerable subgroups. Coronavirus disease 2019 (COVID-19) may similarly impact maternal health. This study aimed to characterize the effect of COVID-19 on the incidence of PPD and to identify vulnerable subgroups. Retrospective chart review of maternal-newborn dyads was conducted over two epochs: pre-COVID-19 (January 1-June 1, 2019) and during-COVID-19 (January 1-June 1, 2020). PPD was defined as an Edinburgh Postnatal Depression Scale score of ≧ 10 at any postnatal appointment. Prevalence of depression and anxiety was recorded. Data were analyzed using chi-square, Mann-Whitney, and -tests. Among 1061 dyads (557 in the 2019 epoch, 504 in the 2020 epoch), the epochs had similar clinical and demographic characteristics. Incidence proportion of PPD was similar (16.9% to 18.1%, = 0.67). In subgroup analyses, this outcome was also similar among primiparous mothers (17.4% to 22.2%, = 0.22) and publicly insured mothers (23.9% to 25.9%, = 0.78). The 2020 epoch exhibited higher prevalence of current depression (9.9% to 14.3%, = 0.03) and anxiety (10.1% to 18.7%, < 0.001). However, incidence proportion of PPD decreased among women with current mental health diagnoses (41.5% to 31.3%, = 0.19). A stable PPD incidence despite increased prevalence of current mood disorders highlights the complexity of the biopsychosocial milieu contributing to PPD. Further study of psychiatric care access and treatment is an important next step in understanding relationships between current mood disorders and PPD during the pandemic.
研究考察了自然灾害的影响，指出在抑郁症稳定发生率的背景下，脆弱亚组的产后抑郁症（PPD）增加。2019 年冠状病毒病（COVID-19）可能同样会影响产妇健康。本研究旨在描述 COVID-19 对 PPD 发生率的影响，并确定脆弱亚组。对两个时期的母婴对进行了回顾性图表审查：COVID-19 之前（2019 年 1 月 1 日至 6 月 1 日）和 COVID-19 期间（2020 年 1 月 1 日至 6 月 1 日）。PPD 的定义是任何产后预约时爱丁堡产后抑郁量表评分≧10。记录了抑郁和焦虑的患病率。使用卡方检验、曼-惠特尼检验和 t 检验进行数据分析。在 1061 对母婴对（2019 年时 557 对，2020 年时 504 对）中，两个时期具有相似的临床和人口统计学特征。PPD 的发病率比例相似（16.9%至 18.1%，=0.67）。在亚组分析中，初产妇（17.4%至 22.2%，=0.22）和公共保险母亲（23.9%至 25.9%，=0.78）中也有类似的结果。2020 年时期当前抑郁（9.9%至 14.3%，=0.03）和焦虑（10.1%至 18.7%，<0.001）的患病率更高。然而，当前有心理健康诊断的女性中 PPD 的发病率比例下降（41.5%至 31.3%，=0.19）。尽管当前心境障碍的患病率增加，但 PPD 的发病率保持稳定，突出了导致 PPD 的生物心理社会环境的复杂性。进一步研究精神病护理的获得和治疗是理解大流行期间当前心境障碍与 PPD 之间关系的重要下一步。
