Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland; Centre for Chronobiology, University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.
Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland.
J Affect Disord. 2022 Nov 15;317:245-255. doi: 10.1016/j.jad.2022.08.064. Epub 2022 Aug 31.
Perinatal depression (PND) is a severe complication of pregnancy, but there are no established risk factors predicting the disease. Evening chronotype has been associated with unhealthy lifestyle habits and adverse outcomes during pregnancy. In this study, we aimed to clarify whether chronotype can predict symptoms and/or occurrence of PND.
Two hundred ninety-nine women were followed-up from the first trimester of pregnancy until 6 months postpartum. Chronotype was assessed at baseline using the MEQ, while mood was repeatedly assessed by depression rating scales (EPDS, HDRS, MADRS). The influence of time and chronotype on EPDS, HDRS and MADRS, was estimated by constructing multilevel linear mixed regression models. A Cox proportional-hazard regression model was built to evaluate the association between chronotype and incidence of depression.
Chronotype modulated PND symptom severity depending on time of assessment, with evening chronotypes having a higher risk for developing PND symptoms, as assessed by EPDS, at postpartum visits V4 (5-12 days) and V5 (19-26 days). These also had less healthy lifestyle habits and were more likely to suffer from gestational diabetes mellitus and undergo cesarean delivery as compared to other chronotypes.
Only a minority of women were classified as evening chronotypes. The long follow-up phase of the study led to missing data.
Pregnant evening chronotypes show unhealthy lifestyle habits and sociodemographic characteristics commonly associated with a higher risk for PND. They also have a higher risk of developing PND symptoms in the first month after delivery. Chronotype should therefore be routinely assessed during pregnancy to identify women potentially at risk for developing PND.
围产期抑郁症（PND）是妊娠的严重并发症，但目前尚无确定的预测该病的风险因素。夜间型已与不健康的生活方式习惯和妊娠不良结局相关。在这项研究中，我们旨在阐明昼夜节律是否可以预测 PND 的症状和/或发生。
从妊娠早期开始，对 299 名女性进行了随访，直到产后 6 个月。使用 MEQ 在基线时评估昼夜节律类型，而使用抑郁评定量表（EPDS、HDRS、MADRS）反复评估情绪。通过构建多层次线性混合回归模型来估计时间和昼夜节律类型对 EPDS、HDRS 和 MADRS 的影响。建立 Cox 比例风险回归模型来评估昼夜节律类型与抑郁发生率之间的关联。
昼夜节律类型根据评估时间调节 PND 症状的严重程度，与其他昼夜节律类型相比，夜间型在产后访视 V4（5-12 天）和 V5（19-26 天）时发生 PND 症状的风险更高，通过 EPDS 评估。她们的生活方式也更不健康，更有可能患妊娠期糖尿病和接受剖宫产。
只有少数女性被归类为夜间型。研究的长期随访阶段导致数据缺失。
妊娠夜间型表现出不健康的生活方式习惯和与 PND 风险增加相关的社会人口特征。她们在产后第一个月发生 PND 症状的风险也更高。因此，在怀孕期间应常规评估昼夜节律类型，以识别可能有发生 PND 风险的女性。
