Usui Yuriko, Takegata Mizuki, Takeda Satoru, Kitamura Toshinori
Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan.
Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan.
Healthcare (Basel). 2023 Jan 27;11(3):361. doi: 10.3390/healthcare11030361.
Little is known about the causality of antenatal depression (AND). We focused on the causal relationships between AND, fear of childbirth (FOC), and obsessive-compulsive symptoms (OCS) during the COVID-19 pandemic in Japan. We also examined whether the perceived threat of COVID-19 is associated with AND. Participants were recruited for an Internet survey conducted in December 2020. A total of 245 pregnant women completed the online survey at 12 to 15 weeks' gestational age (Time 1) and approximately 10 weeks later (Time 2). AND was estimated using the first two diagnostic items of Major Depressive Episode. The estimated prevalence of AND was 4.5% and 2.9% at Time 1 and Time 2, respectively. At both time points, no association was found between AND and the perception of COVID-19 threat. Structural equation modeling showed that AND predicted OCS (β = 0.16, < 0.001), which, in turn, predicted FOC (β = 0.09, = 0.042); FOC, in turn, predicted AND (β = 0.23, < 0.001). AND, OCS, and FOC were predicted by borderline personality traits. Insecure adult attachment influenced AND and FOC via the perceived negative impact of the current pregnancy. Perinatal care providers should assess the personality and perception of pregnancy to prevent depression and pay attention to symptoms such as FOC and OCS in addition to those of depression.
关于产前抑郁症（AND）的因果关系，我们所知甚少。我们重点研究了日本新冠疫情期间AND、分娩恐惧（FOC）和强迫症状（OCS）之间的因果关系。我们还研究了对新冠疫情的感知威胁是否与AND有关。参与者通过2020年12月进行的一项网络调查招募。共有245名孕妇在孕12至15周时（时间1）以及大约10周后（时间2）完成了在线调查。使用重度抑郁发作的前两项诊断项目来评估AND。AND在时间1和时间2的估计患病率分别为4.5%和2.9%。在两个时间点，均未发现AND与对新冠疫情威胁的感知之间存在关联。结构方程模型显示，AND可预测OCS（β = 0.16，< 0.001），而OCS又可预测FOC（β = 0.09， = 0.042）；FOC反过来又可预测AND（β = 0.23，< 0.001）。AND、OCS和FOC可由边缘性人格特质预测。不安全的成人依恋通过当前妊娠的感知负面影响影响AND和FOC。围产期护理人员应评估孕妇的个性和对妊娠的认知，以预防抑郁症，除抑郁症症状外，还应关注FOC和OCS等症状。
