Orsolini Laura, Pompili Simone, Mauro Antonella, Volpe Umberto
Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy.
Healthcare (Basel). 2023 Feb 2;11(3):428. doi: 10.3390/healthcare11030428.
Perinatal depression (PND) represents one of the most common mental disorders in the pregnancy and/or postpartum period, with a 5-25% prevalence rate. Our aim was to investigate predictors associated with PND in a cohort of pregnant and puerperal women based in an Italian setting during the COVID-19 pandemic. We retrospectively recruited 199 (55 pregnant and 144 puerperal) women, afferent to our Perinatal Mental Outpatient Service of Ancona (Italy). Participants were administered an ad hoc case-report form, Whooley Questions (WQ), the General Health Questionnaire-12 (GHQ-12), the Stress Holmes-Rahe scale (HR) and the Edinburgh Postnatal Depression Scale (EPDS). Around 10% of the sample had a confirmed PND. Being a foreigner woman (RR = 3.8), having a positive psychiatric family history (RR = 5.3), a pre-pregnancy medical comorbidity (RR = 1.85) and a comorbid medical illness occurring during the pregnancy (RR = 2) were much likely associated with PND. Multiple linear regression analysis demonstrated that GHQ, medium- and high-risk at the HR, foreign nationality, positive family psychiatric history, and neoplastic disease before conception significantly predicted EPDS [(1, 197) = 10.086, = 0.324, < 0.001]. The sample size, poor heterogeneity in terms of socio-demographic, clinical and gynecological-obstetric characteristics, the cross-sectional design of the study. Our study showed a set of predictors associated with a higher risk for the PND onset, including gestational and pregestational medical disease. Our findings outline the need to screen all fertile women, particularly in gynecological and medical settings, in order to identify at-risk women for PND and promptly suggest a psychiatric consultation.
围产期抑郁症（PND）是妊娠和/或产后最常见的精神障碍之一，患病率为5%-25%。我们的目的是在新冠疫情期间，对意大利一组孕妇和产妇中与PND相关的预测因素进行调查。我们回顾性招募了199名（55名孕妇和144名产妇）前往意大利安科纳围产期精神科门诊服务中心就诊的女性。参与者填写了一份专门设计的病例报告表、Whooley问题（WQ）、一般健康问卷-12（GHQ-12）、应激霍姆斯-拉赫量表（HR）和爱丁堡产后抑郁量表（EPDS）。约10%的样本确诊为PND。外籍女性（相对危险度=3.8）、有精神疾病家族史（相对危险度=5.3）、孕前有内科合并症（相对危险度=1.85）以及孕期出现内科合并症（相对危险度=2）与PND的关联性更强。多元线性回归分析表明，GHQ、HR量表中的中高风险、外籍、家族精神病史阳性以及孕前患有肿瘤疾病显著预测了EPDS得分[F(1, 197)=10.086，R²=0.324，P<0.001]。本研究存在样本量问题、社会人口学、临床及妇产科特征方面异质性差以及研究为横断面设计等局限性。我们的研究显示了一组与PND发病风险较高相关的预测因素，包括孕期和孕前的内科疾病。我们的研究结果表明，有必要对所有育龄妇女进行筛查，尤其是在妇科和内科环境中，以便识别出有PND风险的妇女并及时建议其进行精神科咨询。
