孕期精神障碍的经历：黎巴嫩妇女产前抑郁和焦虑的体验。
Traversing mental health disorders during pregnancy: Lebanese women's experiences of antepartum depression and anxiety.
机构信息
School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
出版信息
Ir J Med Sci. 2023 Dec;192(6):2949-2959. doi: 10.1007/s11845-023-03371-0. Epub 2023 Apr 20.
INTRODUCTION
Over the past few years, Lebanon-a developing country-has faced a plethora of economic and political challenges, with more than half of the general population presenting depressive and anxiety symptoms. However, when it comes to maternal mental health during pregnancy, the last examination in Lebanon dates far back to 2005. Our study's aim was to help delineate the factors associated with Lebanese women's mental health disorders during pregnancy, namely antepartum depression and anxiety.
METHODS
We launched a cross-sectional study among Lebanese pregnant women (age ≥ 18 years) between June and July 2021, during the COVID-19 lockdown (N = 433).
RESULTS
In total, 87.8% of the participants experienced depression (mild to severe), where severe depression was observed in 7.9%. In addition, 70.3% had a significant level of anxiety. Increased pregnancy-specific hassles (beta = 0.93), being Muslim compared to Christians (beta = 3.19), being afraid of an existing aggressor (beta = 8.75), urinary tract infections (beta = 2.02), and higher gestational age (beta = 0.07) were significantly associated with higher depression, whereas higher physical activity index (beta = - 0.09) and increased disordered eating attitudes during pregnancy (beta = - 0.27) were significantly associated with less depression, all accounting for 60.4% of the model's variance. Additionally, increased pregnancy-specific hassles (beta = 0.54), being Muslim compared to Christians (beta = 2.42), urinary tract infections (beta = 1.72), and having been emotionally or physically abused (beta = 1.19) were significantly associated with higher levels of anxiety and could predict 49% of the total variance.
CONCLUSION
Our study has suggested the existence of factors that have additive effects in potentiating the risk for depression and anxiety among Lebanese pregnant women, namely cultural beliefs, pregnancy-related distress, medical complications during pregnancy, and a history of abuse. Therefore, it would be judicious to implement screening programs targeting pregnant women at risk for antepartum depression and anxiety. In addition, high rates of prenatal depression and anxiety were detected among our sample, supporting that recognizing and treating maternal mental health disorders should be prioritized during antenatal care in Lebanon.
简介
在过去的几年里，黎巴嫩——一个发展中国家——面临着大量的经济和政治挑战，超过一半的总人口出现抑郁和焦虑症状。然而，就怀孕期间的产妇心理健康而言，黎巴嫩上一次检查还是在 2005 年。我们的研究旨在帮助确定与黎巴嫩孕妇怀孕期间心理健康障碍相关的因素，即产前抑郁和焦虑。
方法
我们于 2021 年 6 月至 7 月期间在黎巴嫩孕妇（年龄≥18 岁）中开展了一项横断面研究，正值 COVID-19 封锁期间（N=433）。
结果
共有 87.8%的参与者经历了抑郁（轻度至重度），其中 7.9%为重度抑郁。此外，70.3%有明显的焦虑水平。增加妊娠特异性困扰（β=0.93）、与基督教徒相比为穆斯林（β=3.19）、害怕现有攻击者（β=8.75）、尿路感染（β=2.02）和较高的孕龄（β=0.07）与较高的抑郁显著相关，而较高的身体活动指数（β=-0.09）和怀孕期间饮食失调的增加（β=-0.27）与较低的抑郁显著相关，这两个因素共占模型方差的 60.4%。此外，增加妊娠特异性困扰（β=0.54）、与基督教徒相比为穆斯林（β=2.42）、尿路感染（β=1.72）和情感或身体虐待（β=1.19）与较高的焦虑水平显著相关，可预测总方差的 49%。
结论
我们的研究表明，在黎巴嫩孕妇中，存在一些因素具有叠加效应，可能增加患产前抑郁和焦虑的风险，这些因素包括文化信仰、与妊娠相关的困扰、妊娠期间的医疗并发症以及遭受虐待的经历。因此，有必要针对产前抑郁和焦虑高危孕妇实施筛查计划。此外，我们的样本中检测到较高的产前抑郁和焦虑发生率，这支持在黎巴嫩的产前保健中应优先重视识别和治疗产妇心理健康障碍。
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