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巴西队列研究中分娩后 6 个月内的早产和产后抑郁。

Preterm birth and postpartum depression within 6 months after childbirth in a Brazilian cohort.

机构信息

Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

Department of Public Health, São Luís Medical School, Federal University of Maranhão, São Luís, Brazil.

出版信息

Arch Womens Ment Health. 2022 Oct;25(5):929-941. doi: 10.1007/s00737-022-01248-2. Epub 2022 Jul 18.

Abstract

Preterm birth (PTB) and postpartum depression (PPD) are important public health issues, and although literature mainly supports the association between them, some reviews have highlighted methodological limitations in the studies in this field, restricting the interpretation of such finding. This study aimed at assessing the association between PTB and PPD, by comparing groups of preterm and full-term mothers in two Brazilian cities with contrasting sociodemographic indicators. This prospective convenience cohort study assessed 1421 women during pregnancy, at childbirth, and in the postpartum period. The Edinburgh Postnatal Depression Scale (EPDS) was administrated to assess PPD within 6 months after delivery and women were considered probably depressed if scores were EDPS ≥ 12. PTB was defined as the delivery before 37 completed weeks of pregnancy. A multivariate Poisson regression was used to estimate relative risk for PPD in mothers of preterm infants, and the final analysis models were adjusted for psychosocial variables, selected according to the directed acyclic graph (DAG) approach. Frequencies of PPD were not significantly different in mothers of preterm and full-term infants, in neither city. In the final adjusted model, PTB was not associated with PPD. The association between PTB and PPD was not confirmed in two large samples from two Brazilian cities with contrasting socioeconomic profile. However, maternal health during pregnancy plays an important role in predicting PPD. Prenatal care should promote maternal mental health as an effort towards decreasing unfavored outcomes for mothers, infants, and families.

摘要

早产 (PTB) 和产后抑郁症 (PPD) 是重要的公共卫生问题,尽管文献主要支持它们之间的关联,但一些综述强调了该领域研究中存在的方法学限制,限制了对这些发现的解释。本研究旨在通过比较两个具有不同社会人口学指标的巴西城市的早产和足月母亲组,评估 PTB 和 PPD 之间的关联。这项前瞻性便利队列研究评估了 1421 名孕妇、分娩中和产后的女性。使用爱丁堡产后抑郁量表 (EPDS) 在分娩后 6 个月内评估 PPD,得分 EPDS≥12 分的女性被认为可能患有抑郁症。PTB 定义为妊娠 37 周前分娩。使用多变量泊松回归估计早产儿母亲患 PPD 的相对风险,最终分析模型根据有向无环图 (DAG) 方法调整了心理社会变量。在两个城市,早产和足月婴儿的母亲的 PPD 频率均无显著差异。在最终调整的模型中,PTB 与 PPD 无关。在两个具有不同社会经济状况的巴西大城市的两个大样本中,PTB 与 PPD 之间的关联并未得到证实。然而,母亲在怀孕期间的健康状况对预测 PPD 起着重要作用。产前保健应促进产妇的心理健康,以努力减少对母亲、婴儿和家庭不利的后果。

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