Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28, Athens, Greece.
Department of Obstetrics and Gynaecology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Arch Gynecol Obstet. 2024 Sep;310(3):1397-1408. doi: 10.1007/s00404-023-07306-z. Epub 2023 Dec 13.
There is currently a heightened need for perinatal medical services to timely recognize and accurately meet the psychological needs of pregnant women. Psychological disturbances a mother experiences during pregnancy, such as depression and anxiety, can be later associated with inadequate maternal capacity for antenatal care for herself and the baby, and may lead to subsequent mental health problems later in the mother's life. Routine prenatal assessment could significantly benefit from being proactively enriched with early prevention mental health screening tools to assess, appropriately manage vulnerable populations, and subsequently implement preventive actions.
178 pregnant women, under routine prenatal medical assessment, were measured regarding depressive symptomatology and stress, through the use of two validated psychometric tools (the Edinburgh Postnatal Depression Scale (EPDS) and the Perceived Stress Scale (PSS-14)).
Heightened perceived stress and depressive symptomatology levels were associated with younger maternal age, an obstetrical record of more than one births and a history of abortion. Results additionally showed a connection between the requirement for a psychiatric referral-based on the levels of symptomatology recorded through the psychometric assessment and a clinical interview-and currently running the earlier stages (weeks) of pregnancy.
Our revised proposed prenatal screening protocol for depression and stress suggests an amplified follow-up assessment including all pregnant women scoring high in both depression and in perceived stress, regardless of previous history of prenatal depression or of suicidality, to detect earlier or less manifest expressions of distress during pregnancy, in vulnerable perinatal populations.
当前，围产期医疗服务需要及时识别并准确满足孕妇的心理需求。母亲在怀孕期间经历的心理障碍，如抑郁和焦虑，可能会导致其后续无法充分进行产前自我护理和照顾婴儿，并可能导致其在以后的生活中出现心理健康问题。常规产前评估如果能够主动地利用早期预防心理健康筛查工具进行丰富，对脆弱人群进行适当管理，并随后采取预防措施，将显著受益。
通过使用两种经过验证的心理计量学工具（爱丁堡产后抑郁量表 (EPDS) 和感知压力量表 (PSS-14)），对 178 名接受常规产前医疗评估的孕妇进行了抑郁症状和压力评估。
感知到的压力和抑郁症状水平升高与母亲年龄较小、产科记录中有多次分娩史和流产史有关。结果还表明，根据心理计量评估和临床访谈记录的症状水平，需要进行精神病转诊与目前处于妊娠早期（几周）之间存在联系。
我们修订后的产前抑郁和压力筛查方案建议进行更深入的随访评估，包括所有在抑郁和感知压力方面得分较高的孕妇，无论其是否有产前抑郁或自杀史，以在围产期脆弱人群中更早或更不明显地发现怀孕时的痛苦表现。
