Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
BMJ Open. 2023 Jun 23;13(6):e069797. doi: 10.1136/bmjopen-2022-069797.
To assess the feasibility of the family paediatrician's (FP) role in identifying the signs of postpartum depression in parents in time to guarantee child well-being.
DESIGN, SETTING AND PARTICIPANTS: Data for this observational prospective study were collected within the NASCITA (NAscere e creSCere in ITAlia) cohort. During the first visit, paediatricians collected sociodemographic data regarding the parents and information about their health status, the pregnancy and the delivery. Whooley questions were administered during the first and second visits (scheduled 60-90 days after childbirth). Moreover, on the third visit (5-7 months after childbirth) the FP was asked to answer 'yes' or 'no' to a question on the parental postpartum depression, based on his knowledge and on the acquired information.
In 2203 couples who completed the assessment, 529 mothers (19.9%), 141 fathers (6.3%) and 110 (5%) couples reported any depressive symptomatology. Of these, 141 mothers (5.3% of the total sample) and 18 fathers (0.8% of the total sample) were classified as 'likely depressed'. An association was found between maternal postnatal depressive symptoms and having a diagnosed psychiatric disorder during pregnancy (OR 9.49, 95% CI: 3.20 to 28.17), not exclusively breastfeeding at hospital discharge (OR 1.76, 95% CI: 1.19 to 2.61) and the presence of child sleeping disorders at 3 (OR 2.46, 95% CI: 1.41 to 4.28) and 6 months (OR 2.18, 95% CI: 1.37 to 3.47). Another significant predictor of postpartum depression was being primiparous (OR 1.99, 95% CI: 1.31 to 3.02). Concerning the fathers, a significant association was reported only between likely depressed fathers and child sleeping disorders at 3 months (OR 7.64, 95% CI: 2.92 to 19.97). Moreover, having a likely depressed partner was strongly associated with depressive symptoms in fathers (OR 85.53, 95% CI 26.83 to 272.69).
The findings of this study support the feasibility of an active screening programme for parental postnatal depression during well-child visits as an integral part of postpartum care.
NCT03894566; Pre-results.
评估家庭儿科医生（FP）及时识别父母产后抑郁迹象的可行性，以保障儿童福祉。
设计、地点和参与者：本观察性前瞻性研究的数据来自 NASCITA（NAscere e creSCere in ITAlia）队列。在第一次就诊时，儿科医生收集了父母的社会人口学数据以及他们的健康状况、妊娠和分娩信息。在第一次和第二次就诊时（产后 60-90 天预约）进行了 Whooley 问题调查。此外，在第三次就诊（产后 5-7 个月）时，根据 FP 的知识和所获得的信息，询问他是否认为父母有产后抑郁。
在完成评估的 2203 对夫妇中，529 名母亲（19.9%）、141 名父亲（6.3%）和 110 对夫妇（5%）报告有任何抑郁症状。其中，141 名母亲（占总样本的 5.3%）和 18 名父亲（占总样本的 0.8%）被归类为“可能抑郁”。母亲产后抑郁症状与怀孕期间诊断出的精神疾病（OR 9.49，95%CI：3.20 至 28.17）、产后医院不进行纯母乳喂养（OR 1.76，95%CI：1.19 至 2.61）和 3 个月（OR 2.46，95%CI：1.41 至 4.28）和 6 个月（OR 2.18，95%CI：1.37 至 3.47）儿童睡眠障碍有关。产后抑郁的另一个显著预测因素是初产妇（OR 1.99，95%CI：1.31 至 3.02）。至于父亲，只有在 3 个月时可能抑郁的父亲与儿童睡眠障碍之间存在显著关联（OR 7.64，95%CI：2.92 至 19.97）。此外，有一个可能抑郁的伴侣与父亲的抑郁症状密切相关（OR 85.53，95%CI 26.83 至 272.69）。
这项研究的结果支持在儿童健康检查期间对父母产后抑郁进行积极筛查的可行性，作为产后护理的一个组成部分。
NCT03894566；预结果。
