Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, 518000, Guangdong Province, China.
Shenzhen Key Laboratory of Maternal and Child Health and Diseases, Shenzhen, 518000, Guangdong Province, China.
BMC Pregnancy Childbirth. 2024 Jul 16;24(1):480. doi: 10.1186/s12884-024-06680-z.
Antenatal depression is a significant public health issue affecting pregnant women both globally and in China. Using data from a mobile app-based screening programme, this study explored the prevalence and factors associated with antenatal depressive symptoms across different trimesters in Shenzhen.
A retrospective cross-sectional study was conducted on pregnant women who gave birth in any hospital in Shenzhen between July 2021 and May 2022 and underwent depression screening using an official maternal and infant health mobile app at least once during pregnancy. Depressive symptoms were evaluated using the 9-item Patient Health Questionnaire (PHQ-9), with cut-off scores of 5 and 10 for mild and high level of symptoms, respectively. The prevalence for each trimester was determined by calculating the proportion of women scoring 5 or higher. A variety of sociodemographic, obstetric, psychological, and lifestyle factors were assessed for their association with depressive symptoms. Chi-square test and multivariate logistic regression were performed to identify significant predictors.
A total of 110,584 pregnant women were included in the study, with an overall prevalence of depressive symptoms of 18.0% and a prevalence of high-level symptoms of 4.2%. Depressive symptoms were most prevalent in the first trimester (10.9%) and decreased in the second (6.2%) and third trimesters (6.3%). Only a small proportion (0.4%) of women showed persistent depressive symptoms across all trimesters. Anxiety symptoms in early pregnancy emerged as the most significant predictor of depressive symptoms. Other factors linked to an increased risk throughout pregnancy include lower marital satisfaction, living with parents-in-law, experience of negative life events, as well as drinking before and during pregnancy. Factors associated with a reduced risk throughout pregnancy include multiparity and daily physical activity.
This large-scale study provides valuable insights into the prevalence and factors associated with antenatal depressive symptoms in Shenzhen. The findings underscore the need for targeted interventions for high-risk groups and the integration of mental health care into routine antenatal services. Continuous, dynamic monitoring of depressive symptoms for pregnant women and ensuring at-risk women receive comprehensive follow-up and appropriate psychological or psychiatric care are crucial for effectively addressing antenatal depression and improving maternal and infant health outcomes.
产前抑郁症是一个全球性的重大公共卫生问题，在中国也同样存在，影响着孕妇的身心健康。本研究使用基于移动应用程序的筛查项目的数据，探讨了深圳不同孕期产前抑郁症状的流行情况及其相关因素。
本研究采用回顾性横断面研究设计，对 2021 年 7 月至 2022 年 5 月期间在深圳任何一家医院分娩的孕妇进行研究，这些孕妇在孕期至少使用官方母婴健康移动应用程序进行了一次抑郁筛查。使用 9 项患者健康问卷（PHQ-9）评估抑郁症状，得分 5 分和 10 分分别表示轻度和高度症状。通过计算得分 5 或更高的女性比例来确定每个孕期的患病率。评估了各种社会人口学、产科、心理和生活方式因素与抑郁症状的关系。采用卡方检验和多因素 logistic 回归分析确定显著预测因素。
本研究共纳入 110584 名孕妇，总体抑郁症状患病率为 18.0%，高度症状患病率为 4.2%。抑郁症状在孕早期最为常见（10.9%），在孕中期（6.2%）和孕晚期（6.3%）逐渐减少。只有一小部分（0.4%）的女性在所有孕期都持续出现抑郁症状。孕早期的焦虑症状是抑郁症状的最重要预测因素。与整个孕期风险增加相关的其他因素包括婚姻满意度较低、与公婆同住、经历负性生活事件、以及在怀孕前和怀孕期间饮酒。与整个孕期风险降低相关的因素包括多胎妊娠和每日体育活动。
这项大规模研究提供了有关深圳产前抑郁症状的流行情况及其相关因素的宝贵信息。研究结果强调需要针对高危人群进行有针对性的干预措施，并将心理健康护理纳入常规产前服务。持续、动态监测孕妇的抑郁症状，确保高危孕妇得到全面随访和适当的心理或精神病学护理，对于有效解决产前抑郁问题、改善母婴健康结局至关重要。
