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产后六个月抑郁护理的M-DEPTH模型对母亲功能和婴儿发育结局的影响:一项整群随机对照试验的结果

Effects of M-DEPTH Model of Depression Care on Maternal Functioning and Infant Developmental Outcomes in the Six Months Post Delivery: Results from a Cluster Randomized Controlled Trial.

作者信息

Wagner Glenn J, Ghosh-Dastidar Bonnie, Faherty Laura, Beyeza-Kashesya Jolly, Nakku Juliet, Nabitaka Linda Kisaakye, Akena Dickens, Nakigudde Janet, Ngo Victoria, McBain Ryan, Lukwata Hafsa, Gwokyalya Violet, Mukasa Barbara, Wanyenze Rhoda K

机构信息

RAND Corporation, Santa Monica, CA, USA.

Boston University School of Medicine, Boston, MA, USA.

出版信息

Womens Reprod Health (Phila). 2024;11(2):313-328. doi: 10.1080/23293691.2023.2255587. Epub 2023 Oct 18.

Abstract

Perinatal depression has been shown to have deleterious effects on maternal post-partum functioning, as well as early child development. However, few studies have documented whether depression care helps to mitigate these effects. We examined the effects of the M-DEPTH (Maternal Depression Treatment in HIV) depression care model (including antidepressants and individual Problem Solving Therapy) on maternal functioning and infant development in the first 6 months post-delivery in an ongoing cluster randomized controlled trial of 391 HIV-infected women with at least mild depressive symptoms enrolled across eight antenatal care clinics in Uganda. A subsample of 354 (177 in each of the intervention and control groups) had a live birth delivery and comprised the analytic sample, of whom 69% had clinical depression at enrollment; 70% of women in the intervention group (including 96% of those with clinical depression) received depression treatment. Repeated-measures multivariable regression models found that the intervention group reported better infant care, lower parental burden, and greater perceived adequacy of parental support, compared to the control group. These findings suggest that depression care for pregnant women living with HIV is important not only for maternal mental health, but it also helps women to better manage parenting and care for their infant.

摘要

围产期抑郁症已被证明会对产妇产后的功能以及儿童早期发育产生有害影响。然而,很少有研究记录抑郁症护理是否有助于减轻这些影响。在乌干达八家产前护理诊所进行的一项正在进行的整群随机对照试验中,我们研究了M-DEPTH(HIV感染孕产妇抑郁症治疗)抑郁症护理模式(包括抗抑郁药和个体解决问题疗法)对391名至少有轻度抑郁症状的HIV感染女性产后头6个月的孕产妇功能和婴儿发育的影响。一个由354名(干预组和对照组各177名)组成的子样本进行了活产分娩,构成了分析样本,其中69%在入组时有临床抑郁症;干预组中70%的女性(包括96%的临床抑郁症患者)接受了抑郁症治疗。重复测量多变量回归模型发现,与对照组相比,干预组报告的婴儿护理情况更好、父母负担更低,并且父母支持的感知充足性更高。这些发现表明,为感染HIV的孕妇提供抑郁症护理不仅对产妇心理健康很重要,而且还能帮助女性更好地管理育儿并照顾婴儿。

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The effects of psychological treatment of perinatal depression: an overview.围产期抑郁症的心理治疗效果:概述。
Arch Womens Ment Health. 2021 Oct;24(5):801-806. doi: 10.1007/s00737-021-01159-8. Epub 2021 Jul 6.

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